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General NPI Number Information
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NPI Number | 1053493536
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Entity Type | Individual
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Provider Name | JAMES ANTHONY NGUYEN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10715 S PRAIRIE AVE
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City | INGLEWOOD
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State | CA
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Zip | 90303-2113
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Country | US
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Telephone | 310-419-6463
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Fax |
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Provider Business Mailing Address
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Address Line | 2023 GRAHAM AVE
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City | REDONDO BEACH
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State | CA
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Zip | 90278-1922
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Country | US
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Telephone | 310-946-1052
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 34391
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License Number State | CA
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