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General NPI Number Information
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NPI Number | 1619742269
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Entity Type | Individual
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Provider Name | MATTHEW NGUYEN DDS
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Gender | Male
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Dates
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Enumeration Date | 11/22/2023
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 7224 MITSCHER WAY
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City | SAN DIEGO
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State | CA
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Zip | 92145-2210
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Country | US
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Telephone | 858-307-1826
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Fax |
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Provider Business Mailing Address
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Address Line | 8583 AERO DR APT 4012
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City | SAN DIEGO
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State | CA
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Zip | 92123-1488
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Country | US
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Telephone | 209-627-7955
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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 | 14107065-9926
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License Number State | UT
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