MEDICARE: DR. VINCENT HUY NGUYEN DDS

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	122300000X	Dentist	48757	CA

General Provider Information

NPI Number	:	1467557033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT HUY NGUYEN DDS

Provider Business Mailing Address
First Line	:	8270 MIRA MESA BLVD
Second Line	:	SUITE D
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-2634
Country	:	US
Telephone Number	:	858-578-4677
Fax Number	:	858-605-6774

Provider Business Practice Location Address
First Line	:	8270 MIRA MESA BLVD
Second Line	:	SUITE D
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-2634
Country	:	US
Telephone Number	:	858-578-4677
Fax Number	:	858-605-6774

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	03/16/2016

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