Provider Demographics
NPI:1811198823
Name:NGUYEN, DIEMPHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIEMPHI
Middle Name:
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 1:1610 WILLOWHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5646
Mailing Address - Country:US
Mailing Address - Phone:858-761-4098
Mailing Address - Fax:
Practice Address - Street 1:1610 WILLOWHAVEN RD
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5646
Practice Address - Country:US
Practice Address - Phone:858-761-4098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44343122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist