Provider Demographics
NPI:1821585266
Name:ANTHONY NGUYEN DDS INC
Entity Type:Organization
Organization Name:ANTHONY NGUYEN DDS INC
Other - Org Name:SMILE AGAIN DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-307-8797
Mailing Address - Street 1:1125 E 17TH ST STE N156
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-2215
Mailing Address - Country:US
Mailing Address - Phone:714-852-3140
Mailing Address - Fax:714-760-4131
Practice Address - Street 1:1125 E 17TH ST STE N156
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-2215
Practice Address - Country:US
Practice Address - Phone:714-852-3140
Practice Address - Fax:714-760-4131
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANTHONY NGUYEN DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-20
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41290305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization