Provider Demographics
NPI:1770952509
Name:NGUYEN, JENNY TUYET (RDH)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:TUYET
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7544 IVY AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-9307
Mailing Address - Country:US
Mailing Address - Phone:714-725-4025
Mailing Address - Fax:
Practice Address - Street 1:7544 IVY AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-9307
Practice Address - Country:US
Practice Address - Phone:714-725-4025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28997124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist