Provider Demographics
NPI:1881790152
Name:NGUYEN, TUYET-BINH (DDS)
Entity type:Individual
Prefix:DR
First Name:TUYET-BINH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:JOANNA
Other - Middle Name:TB
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:5210 W. FIRST STREET
Mailing Address - Street 2:SUITE F
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-3000
Mailing Address - Country:US
Mailing Address - Phone:714-554-6878
Mailing Address - Fax:
Practice Address - Street 1:5210 W. FIRST STREET
Practice Address - Street 2:SUITE F
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-3000
Practice Address - Country:US
Practice Address - Phone:714-554-6878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA364031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA36403OtherDENTIST LICENSE
CAB3640301OtherDENTICAL PROVIDER NUMBER