Provider Demographics
NPI:1942371257
Name:NGUYEN, LUAN DINH (DDS)
Entity Type:Individual
Prefix:DR
First Name:LUAN
Middle Name:DINH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26700 TOWNE CENTRE DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2844
Mailing Address - Country:US
Mailing Address - Phone:949-595-4322
Mailing Address - Fax:949-398-0199
Practice Address - Street 1:26700 TOWNE CENTRE DR
Practice Address - Street 2:SUITE 140
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2844
Practice Address - Country:US
Practice Address - Phone:949-595-4322
Practice Address - Fax:949-398-0199
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA517691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice