Provider Demographics
NPI:1306113089
Name:THUY-ANH P. NGUYEN, DDS, INC.
Entity type:Organization
Organization Name:THUY-ANH P. NGUYEN, DDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THUY-ANH
Authorized Official - Middle Name:PHAM
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-303-5475
Mailing Address - Street 1:4950 BARRANCA PKWY
Mailing Address - Street 2:SUITE 309
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4671
Mailing Address - Country:US
Mailing Address - Phone:949-552-5055
Mailing Address - Fax:949-552-6613
Practice Address - Street 1:4950 BARRANCA PKWY
Practice Address - Street 2:SUITE 309
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604
Practice Address - Country:US
Practice Address - Phone:949-552-5055
Practice Address - Fax:949-552-6613
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOODBRIDGE DENTISTRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-22
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA471401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty