Provider Demographics
NPI:1790147502
Name:COMFORT DENTAL
Entity Type:Organization
Organization Name:COMFORT DENTAL
Other - Org Name:JULIAN L. NGUYEN DMD, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:626-792-1755
Mailing Address - Street 1:1090 LINDA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103
Mailing Address - Country:US
Mailing Address - Phone:626-792-1755
Mailing Address - Fax:
Practice Address - Street 1:9040 HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91775
Practice Address - Country:US
Practice Address - Phone:626-792-1755
Practice Address - Fax:626-872-1901
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMFORT DENTAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-22
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA440461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty