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General NPI Number Information
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NPI Number | 1568683266
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Entity Type | Organization
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Legal Business Name | DOUGLAS NGUYEN, DDS, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 9600 BOLSA AVE SUITE E
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City | WESTMINSTER
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State | CA
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Zip | 92683
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Country | US
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Telephone | 714-839-9800
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Fax | 714-839-9894
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Provider Business Mailing Address
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Address Line | 9600 BOLSA AVE SUITE E
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City | WESTMINSTER
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State | CA
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Zip | 92683
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Country | US
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Telephone | 714-839-9800
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Fax | 714-839-9894
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Authorized Official
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Title or Position | CEO
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Name | MR. DOUGLAS DUC TIEN NGUYEN
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Credential | DDS
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Telephone | 714-839-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 40970
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License Number State | CA
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