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General NPI Number Information
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NPI Number | 1720203631
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Entity Type | Individual
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Provider Name | JULIAN L NGUYEN DMD
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Gender | Male
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | 1090 LINDA VISTA AVE
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City | PASADENA
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State | CA
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Zip | 91103-2749
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Country | US
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Telephone | 626-316-2480
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Fax |
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Provider Business Mailing Address
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Address Line | 9040 HUNTINGTON DR.
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City | SAN GABRIEL
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State | CA
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Zip | 91775
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Country | US
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Telephone | 626-792-1755
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Fax | 626-872-1901
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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 | 44046
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License Number State | CA
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