Provider Demographics
NPI:1194943563
Name:NGUYEN, SCOTT HIEN GIA
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:HIEN GIA
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6180 JARVIS AVE
Mailing Address - Street 2:SUITE J
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-1263
Mailing Address - Country:US
Mailing Address - Phone:510-795-9669
Mailing Address - Fax:510-795-1404
Practice Address - Street 1:6180 JARVIS AVE
Practice Address - Street 2:SUITE J
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-1263
Practice Address - Country:US
Practice Address - Phone:510-795-9669
Practice Address - Fax:510-795-1404
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA403791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice