Provider Demographics
NPI:1285309377
Name:CHAU, NHU QUYNH (DDS)
Entity type:Individual
Prefix:
First Name:NHU
Middle Name:QUYNH
Last Name:CHAU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7442 SONOMA CREEK CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-1878
Mailing Address - Country:US
Mailing Address - Phone:909-374-4888
Mailing Address - Fax:
Practice Address - Street 1:1182 E HOLT AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-5833
Practice Address - Country:US
Practice Address - Phone:909-374-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106831122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist