Provider Demographics
NPI:1124095930
Name:TRAN-NGUYEN, QUYNH ANH (DMD)
Entity type:Individual
Prefix:DR
First Name:QUYNH
Middle Name:ANH
Last Name:TRAN-NGUYEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 NEWBURY RD
Mailing Address - Street 2:SUITE #138
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-3613
Mailing Address - Country:US
Mailing Address - Phone:805-498-8856
Mailing Address - Fax:805-498-8867
Practice Address - Street 1:1000 NEWBURY RD
Practice Address - Street 2:SUITE #138
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-3613
Practice Address - Country:US
Practice Address - Phone:805-498-8856
Practice Address - Fax:805-498-8867
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA521541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice