Basic Information
| Provider Information | |||||||||
| NPI: | 1518372705 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | HUY | ||||||||
| MiddleName: | QUANG | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8432 TULIPWOOD CIR | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926836336 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1680 E HILL ST | ||||||||
| Address2: | |||||||||
| City: | SIGNAL HILL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907553612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624246200 | ||||||||
| FaxNumber: | 5629815074 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2014 | ||||||||
| LastUpdateDate: | 06/25/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 63490 | CA | Y | Dental Providers | Dentist | General Practice |
No ID Information.