Provider Demographics
NPI:1861487985
Name:NGUYEN, MINH-PHUONG NGOC (DDS)
Entity Type:Individual
Prefix:DR
First Name:MINH-PHUONG
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MINH PHUONG
Other - Middle Name:NGUYEN
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1318 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-1713
Mailing Address - Country:US
Mailing Address - Phone:661-725-7400
Mailing Address - Fax:
Practice Address - Street 1:1318 HIGH ST
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-1713
Practice Address - Country:US
Practice Address - Phone:661-725-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA406951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD40695OtherDENTICAL/HEALTHY FAMILY #