Provider Demographics
NPI:1760498091
Name:DANIEL NGUYEN DDS INC
Entity Type:Organization
Organization Name:DANIEL NGUYEN DDS INC
Other - Org Name:CHINO SPECTRUM DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:DT
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-627-9996
Mailing Address - Street 1:4036 GRAND AVE
Mailing Address - Street 2:STE D
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710
Mailing Address - Country:US
Mailing Address - Phone:909-627-9996
Mailing Address - Fax:909-517-1035
Practice Address - Street 1:4036 GRAND AVE
Practice Address - Street 2:STE D
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710
Practice Address - Country:US
Practice Address - Phone:909-627-9996
Practice Address - Fax:909-517-1035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47531122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty