Provider Demographics
NPI:1861974693
Name:HUY C. NGUYEN, DDS, INC.
Entity type:Organization
Organization Name:HUY C. NGUYEN, DDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:T
Authorized Official - Last Name:AVANCENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-665-8999
Mailing Address - Street 1:2400 W LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-6401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2400 WEST LINCON AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-9280
Practice Address - Country:US
Practice Address - Phone:818-665-8999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUY C. NGUYEN, DDS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50084261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental