Provider Demographics
NPI:1982827572
Name:NGUYEN, NANCY NHUNG
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:NHUNG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10965 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4929
Mailing Address - Country:US
Mailing Address - Phone:714-636-8468
Mailing Address - Fax:714-636-0873
Practice Address - Street 1:10965 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4929
Practice Address - Country:US
Practice Address - Phone:714-636-8468
Practice Address - Fax:714-636-0873
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG90966-01OtherCALIFORNIA DENTICAL