Provider Demographics
NPI:1962856617
Name:DAO-NGUYEN, JULIE (RDHAP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:DAO-NGUYEN
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2735
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95759-2735
Mailing Address - Country:US
Mailing Address - Phone:916-678-0575
Mailing Address - Fax:
Practice Address - Street 1:9961 WYLAND DR
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-4642
Practice Address - Country:US
Practice Address - Phone:209-470-3751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-19
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDHAP 607124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist