Provider Demographics
NPI:1881295384
Name:JIMMY NGUYEN DDS INC
Entity type:Organization
Organization Name:JIMMY NGUYEN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-276-2877
Mailing Address - Street 1:13089 PEYTON DR. STE. B
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709
Mailing Address - Country:US
Mailing Address - Phone:909-548-3031
Mailing Address - Fax:909-548-3047
Practice Address - Street 1:13089 PEYTON DR. STE. B
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709
Practice Address - Country:US
Practice Address - Phone:909-548-3031
Practice Address - Fax:909-548-3047
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JIMMY NGUYEN, DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty