MEDICARE: DR. CHARLENE THUY - NHUNG NGUYEN DMD

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	111728	CA

General Provider Information

NPI Number	:	1326935420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLENE THUY - NHUNG NGUYEN DMD

Provider Business Mailing Address
First Line	:	28080 CLINTON KEITH RD STE 100
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92563-4553
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	28080 CLINTON KEITH RD STE 100
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92563-4553
Country	:	US
Telephone Number	:	951-370-1529
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2025
Last Update Date	:	07/14/2025

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