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NPI Code Detail

MEDICARE: DR. HOLLY NGUYEN DDS

MEDICARE: DR. HOLLY NGUYEN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry48524CA

General Provider Information

NPI Number : 1053421594
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HOLLY NGUYEN DDS
Provider Business Mailing Address
First Line : 2860 MICHELLE
Second Line : 2ND FLOOR
City : IRVINE
State : CA
Zip : 92606-1009
Country : US
Telephone Number : 714-508-3600
Fax Number : 174-368-2092
Provider Business Practice Location Address
First Line : 30592 SANTA MARGARITA PKWY
Second Line : STE. D
City : RANCHO SANTA MARGARITA
State : CA
Zip : 92688-5802
Country : US
Telephone Number : 949-766-5740
Fax Number : 949-766-6506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 07/08/2007

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Directions to “ DR. HOLLY NGUYEN DDS” Practice Location

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