Healthcare Provider Details

I. General information

NPI: 1831917723
Provider Name (Legal Business Name): QUYNH HOANG NGUYEN DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 ALHAMBRA AVE
MARTINEZ CA
94553-3822
US

IV. Provider business mailing address

4040 ALHAMBRA AVE
MARTINEZ CA
94553-3822
US

V. Phone/Fax

Practice location:
  • Phone: 925-957-0148
  • Fax:
Mailing address:
  • Phone: 925-957-0148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. QUYNH NGUYEN
Title or Position: OWNER
Credential: DDS
Phone: 408-531-7376