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General NPI Number Information
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NPI Number | 1821726126
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Entity Type | Individual
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Provider Name | THOMAS NGUYEN DDS
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Gender | Male
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Dates
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Enumeration Date | 08/13/2022
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 4371 LATHAM ST
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City | RIVERSIDE
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State | CA
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Zip | 92501-1706
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Country | US
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Telephone | 833-867-4642
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Fax | 360-462-2757
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Provider Business Mailing Address
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Address Line | 2084 WILD WOODS
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City | UPLAND
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State | CA
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Zip | 91786-8469
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Country | US
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Telephone | 714-725-5281
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 107781
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License Number State | CA
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