Provider Demographics
NPI:1609847151
Name:NGUYEN, TAMKHOI THI (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAMKHOI
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9376 WESTMINSTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4772
Mailing Address - Country:US
Mailing Address - Phone:714-895-4255
Mailing Address - Fax:714-898-8294
Practice Address - Street 1:9376 WESTMINSTER BLVD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4772
Practice Address - Country:US
Practice Address - Phone:714-895-4255
Practice Address - Fax:714-898-8294
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA333461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB33346-01OtherDENTICAL