MEDICARE: DR. DUONG C. NGUYEN D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	40174	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144229527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUONG C. NGUYEN D.D.S

Provider Business Mailing Address
First Line	:	9900 MCFADDEN AVE
Second Line	:	SUITE 204
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-6978
Country	:	US
Telephone Number	:	714-418-2189
Fax Number	:	714-418-2190

Provider Business Practice Location Address
First Line	:	9900 MCFADDEN AVE
Second Line	:	SUITE 204
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-6978
Country	:	US
Telephone Number	:	714-418-2189
Fax Number	:	714-418-2190

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	10/29/2007

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