MEDICARE: VINCENT HUY NGUYEN, DDS, INC

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
1	1223G0001X	General Practice Dentistry	48757	CA

General Provider Information

NPI Number	:	1205006160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VINCENT HUY NGUYEN, DDS, INC

Provider Business Mailing Address
First Line	:	8270 MIRA MESA BLVD STE D
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-2634
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8270 MIRA MESA BLVD STE D
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-2634
Country	:	US
Telephone Number	:	858-578-4677
Fax Number	:	858-605-6774

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VINCENT HUY NGUYEN
Credential	:	D.D.S.
Telephone Number	:	858-578-4677

Provider Enumeration Date	:	03/07/2008
Last Update Date	:	08/02/2013

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