Healthcare Provider Details

I. General information

NPI: 1750297743
Provider Name (Legal Business Name): TU-UYEN PHUOC NGUYEN, D.D.S., DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 E WARNER AVE STE 104
SANTA ANA CA
92707-3277
US

IV. Provider business mailing address

204 E WARNER AVE STE 104
SANTA ANA CA
92707-3277
US

V. Phone/Fax

Practice location:
  • Phone: 714-641-2939
  • Fax:
Mailing address:
  • Phone: 714-414-8808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: TU-UYEN NGUYEN
Title or Position: PRESIDENT
Credential: DDS
Phone: 714-414-8808