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General NPI Number Information
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NPI Number | 1750997011
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Entity Type | Organization
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Legal Business Name | ANISHA NGUYEN DDS PROF. CORP.
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Dates
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Enumeration Date | 09/21/2020
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 5127 W EDINGER AVE STE E
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City | SANTA ANA
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State | CA
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Zip | 92704-1969
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Country | US
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Telephone | 714-775-0650
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Fax |
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Provider Business Mailing Address
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Address Line | 10551 CLAUSSEN ST
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City | GARDEN GROVE
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State | CA
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Zip | 92840-5040
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Country | US
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Telephone | 714-651-6725
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ANISHA NGUYEN
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Credential | DDS
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Telephone | 714-651-6725
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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