Provider Demographics
NPI:1013075324
Name:NGUYEN, DUN G THI PHUONG (DDS)
Entity Type:Individual
Prefix:DR
First Name:DUN G
Middle Name:THI PHUONG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3426 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-2201
Mailing Address - Country:US
Mailing Address - Phone:619-281-2186
Mailing Address - Fax:619-281-2158
Practice Address - Street 1:3426 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-2201
Practice Address - Country:US
Practice Address - Phone:619-281-2186
Practice Address - Fax:619-281-2158
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA427491223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics