Provider Demographics
NPI:1922386077
Name:SH NGUYEN DENTAL CORPORATION
Entity Type:Organization
Organization Name:SH NGUYEN DENTAL CORPORATION
Other - Org Name:GARIN DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-263-1100
Mailing Address - Street 1:31133 MISSION BLVD
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-7603
Mailing Address - Country:US
Mailing Address - Phone:510-471-1500
Mailing Address - Fax:510-471-1501
Practice Address - Street 1:31133 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-7603
Practice Address - Country:US
Practice Address - Phone:510-471-1500
Practice Address - Fax:510-471-1501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA403791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty