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General NPI Number Information
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NPI Number | 1154059194
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Entity Type | Individual
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Provider Name | DANIEL NGUYEN DDS
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Gender | Male
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 12214 LAKEWOOD BLVD STE 102
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City | DOWNEY
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State | CA
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Zip | 90242-2663
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Country | US
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Telephone | 562-273-2050
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Fax |
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Provider Business Mailing Address
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Address Line | 27 ATASCADERO
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City | IRVINE
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State | CA
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Zip | 92602-1093
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Country | US
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Telephone | 714-856-6717
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 107674
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License Number State | CA
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