Provider Demographics
NPI:1891972287
Name:JENNI NGUYEN & CHRISTOPHER NGUYEN, D.D.S,INC.
Entity Type:Organization
Organization Name:JENNI NGUYEN & CHRISTOPHER NGUYEN, D.D.S,INC.
Other - Org Name:MILE SQUARE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNI
Authorized Official - Middle Name:HA
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-839-7660
Mailing Address - Street 1:15972 EUCLID ST STE F
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1133
Mailing Address - Country:US
Mailing Address - Phone:714-839-7660
Mailing Address - Fax:714-839-7693
Practice Address - Street 1:15972 EUCLID ST STE F
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-1133
Practice Address - Country:US
Practice Address - Phone:714-839-7660
Practice Address - Fax:714-839-7693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40287122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty