MEDICARE: JOHN T 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	61994	CA

General Provider Information

NPI Number	:	1396196051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN T NGUYEN DDS INC

Provider Business Mailing Address
First Line	:	1175 BAKER ST
Second Line	:	A4
City	:	COSTA MESA
State	:	CA
Zip	:	92626-4101
Country	:	US
Telephone Number	:	714-227-4477
Fax Number	:

Provider Business Practice Location Address
First Line	:	1175 BAKER ST
Second Line	:	A4
City	:	COSTA MESA
State	:	CA
Zip	:	92626-4101
Country	:	US
Telephone Number	:	714-227-4477
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOHN THAI-HUY NGUYEN
Credential	:	D.D.S.
Telephone Number	:	714-227-4477

Provider Enumeration Date	:	06/23/2016
Last Update Date	:	06/10/2026

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