Provider Demographics
NPI:1487783163
Name:NGUYEN, CHINH TRUONG (DDS)
Entity type:Individual
Prefix:DR
First Name:CHINH
Middle Name:TRUONG
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 1:2520 H STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2800
Mailing Address - Country:US
Mailing Address - Phone:661-665-9336
Mailing Address - Fax:661-631-1116
Practice Address - Street 1:2520 H ST
Practice Address - Street 2:SUITE B
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2800
Practice Address - Country:US
Practice Address - Phone:661-324-1200
Practice Address - Fax:661-324-5858
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44963122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA44963OtherSTATE LICENSE