Provider Demographics
NPI:1487728986
Name:NGUYEN, YEN KIM (DDS)
Entity type:Individual
Prefix:DR
First Name:YEN
Middle Name:KIM
Last Name:NGUYEN
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 1:15251 GALE AVE
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91745-1507
Mailing Address - Country:US
Mailing Address - Phone:626-855-4701
Mailing Address - Fax:626-855-4703
Practice Address - Street 1:15251 GALE AVE
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91745-1507
Practice Address - Country:US
Practice Address - Phone:626-855-4701
Practice Address - Fax:626-855-4703
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45739122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist