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General NPI Number Information
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NPI Number | 1861692097
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Entity Type | Organization
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Legal Business Name | SCOTT NGUYEN, DDS, INC.
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 6180 JARVIS AVE. #J
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City | NEWARK
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State | CA
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Zip | 94560-1200
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Country | US
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Telephone | 510-795-9669
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Fax | 510-795-1404
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Provider Business Mailing Address
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Address Line | 6180 JARVIS AVE. #J
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City | NEWARK
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State | CA
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Zip | 94560-1200
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Country | US
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Telephone | 510-795-9669
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Fax | 510-795-1404
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCOTT NGUYEN
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Credential | DDS
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Telephone | 510-795-9669
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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 | 40379
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License Number State | CA
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