Provider Demographics
NPI:1972795813
Name:NGUYEN, CLARA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLARA
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CLARA
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:12802 VALLEY VIEW ST STE 2
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-2511
Mailing Address - Country:US
Mailing Address - Phone:714-995-9700
Mailing Address - Fax:714-995-2416
Practice Address - Street 1:12802 VALLEY VIEW ST STE 2
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-2511
Practice Address - Country:US
Practice Address - Phone:714-995-9700
Practice Address - Fax:714-995-2416
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA556171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice