Provider Demographics
NPI:1386797934
Name:NGUYEN, TUAN TRI (DDS)
Entity type:Individual
Prefix:
First Name:TUAN
Middle Name:TRI
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13072 WILLAMETTE ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-2138
Mailing Address - Country:US
Mailing Address - Phone:714-590-7900
Mailing Address - Fax:714-590-7996
Practice Address - Street 1:13045 EUCLID ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1333
Practice Address - Country:US
Practice Address - Phone:714-590-7900
Practice Address - Fax:714-590-7996
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA548261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice