MEDICARE: NOLEEN NGUYEN DDS, INC.

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	305S00000X	Point of Service	51117	CA
2	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1699949339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOLEEN NGUYEN DDS, INC.

Provider Business Mailing Address
First Line	:	16903 BEACH BLVD
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-4808
Country	:	US
Telephone Number	:	714-375-0044
Fax Number	:	714-375-0016

Provider Business Practice Location Address
First Line	:	16903 BEACH BLVD
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-4808
Country	:	US
Telephone Number	:	714-375-0044
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NOLEEN NGUYEN
Credential	:	DDS
Telephone Number	:	714-457-4423

Provider Enumeration Date	:	04/14/2008
Last Update Date	:	06/20/2025

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