Provider Demographics
NPI:1699929026
Name:DR. TOAN D NGUYEN, D.D.S., INC.
Entity type:Organization
Organization Name:DR. TOAN D NGUYEN, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TOAN
Authorized Official - Middle Name:DUY
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-926-3354
Mailing Address - Street 1:13345 ARTESIA BLVD
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-1316
Mailing Address - Country:US
Mailing Address - Phone:562-926-3354
Mailing Address - Fax:562-926-9844
Practice Address - Street 1:13345 ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-1316
Practice Address - Country:US
Practice Address - Phone:562-926-3354
Practice Address - Fax:562-926-9844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
305R00000X
CA45302305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization