Healthcare Provider Details

I. General information

NPI: 1699949339
Provider Name (Legal Business Name): NOLEEN NGUYEN DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16903 BEACH BLVD
HUNTINGTON BEACH CA
92647-4808
US

IV. Provider business mailing address

16903 BEACH BLVD
HUNTINGTON BEACH CA
92647-4808
US

V. Phone/Fax

Practice location:
  • Phone: 714-375-0044
  • Fax:
Mailing address:
  • Phone: 714-375-0044
  • Fax: 714-375-0016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number51117
License Number StateCA

VIII. Authorized Official

Name: NOLEEN NGUYEN
Title or Position: OWNER
Credential: DDS
Phone: 714-457-4423