Healthcare Provider Details

I. General information

NPI: 1487585154
Provider Name (Legal Business Name): KRISTIN Y. NGUYEN, DDS, MS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15972 EUCLID ST STE F
FOUNTAIN VALLEY CA
92708-1133
US

IV. Provider business mailing address

15972 EUCLID ST STE F
FOUNTAIN VALLEY CA
92708-1133
US

V. Phone/Fax

Practice location:
  • Phone: 949-616-2625
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: KRISTIN NGUYEN
Title or Position: ORTHODONTIST
Credential:
Phone: 949-616-2625