Healthcare Provider Details

I. General information

NPI: 1447185830
Provider Name (Legal Business Name): NGUYEN GROUP DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8736 VALLEY BLVD STE B
ROSEMEAD CA
91770-1760
US

IV. Provider business mailing address

8736 VALLEY BLVD STE B
ROSEMEAD CA
91770-1760
US

V. Phone/Fax

Practice location:
  • Phone: 323-365-5603
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAN NGUYEN
Title or Position: OWNER
Credential:
Phone: 323-365-5603