Provider Demographics
NPI:1922190982
Name:NGUYEN, NGOC HOANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:NGOC
Middle Name:HOANG
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 1:9390 BIG HORN BLVD
Mailing Address - Street 2:SUITE 175
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7978
Mailing Address - Country:US
Mailing Address - Phone:916-691-0685
Mailing Address - Fax:916-691-0687
Practice Address - Street 1:9390 BIG HORN BLVD
Practice Address - Street 2:SUITE 175
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7978
Practice Address - Country:US
Practice Address - Phone:916-691-0685
Practice Address - Fax:916-691-0687
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48837122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist