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General NPI Number Information
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NPI Number | 1790816064
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Entity Type | Organization
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Legal Business Name | QUYNH A. TRAN-NGUYEN, D.M.D, DENTAL CORPORATION
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1000 NEWBURY RD SUITE #138
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City | THOUSAND OAKS
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State | CA
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Zip | 91320-6435
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Country | US
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Telephone | 805-498-8856
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Fax | 805-498-8867
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Provider Business Mailing Address
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Address Line | 1000 NEWBURY RD SUITE #138
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City | THOUSAND OAKS
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State | CA
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Zip | 91320-6435
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Country | US
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Telephone | 805-498-8856
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Fax | 805-498-8867
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. QUYNH ANH TRAN-NGUYEN
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Credential | D.M.D
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Telephone | 805-498-8856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 52154
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License Number State | CA
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