Provider Demographics
NPI:1528078268
Name:NGUYEN, JOE NINH THUAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:NINH THUAN
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 1:12511 POWAY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-4321
Mailing Address - Country:US
Mailing Address - Phone:858-486-2000
Mailing Address - Fax:858-486-4082
Practice Address - Street 1:12511 POWAY RD
Practice Address - Street 2:SUITE B
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-4321
Practice Address - Country:US
Practice Address - Phone:858-486-2000
Practice Address - Fax:858-486-4082
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA449701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice