Provider Demographics
NPI:1649605148
Name:DUONG NGUYEN DDS INC
Entity type:Organization
Organization Name:DUONG NGUYEN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DUONG
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-455-8326
Mailing Address - Street 1:1075 S WHITE RD
Mailing Address - Street 2:#60
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-3825
Mailing Address - Country:US
Mailing Address - Phone:408-272-8883
Mailing Address - Fax:408-272-2998
Practice Address - Street 1:1075 S WHITE RD
Practice Address - Street 2:#60
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-3825
Practice Address - Country:US
Practice Address - Phone:408-272-8883
Practice Address - Fax:408-272-2998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA58450122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty