Healthcare Provider Details

I. General information

NPI: 1346294824
Provider Name (Legal Business Name): HUONG THIEN NGUYEN DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 N HARBOR BLVD
SANTA ANA CA
92703
US

IV. Provider business mailing address

316 N HARBOR BLVD
SANTA ANA CA
92703
US

V. Phone/Fax

Practice location:
  • Phone: 714-554-9894
  • Fax: 714-554-9658
Mailing address:
  • Phone: 714-554-9894
  • Fax: 714-554-9658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number46901
License Number StateCA

VIII. Authorized Official

Name: DR. HUONG THIEN NGUYEN
Title or Position: PRESIDENT
Credential: DDS
Phone: 714-554-9894