MEDICARE: LOC Q 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
1	122300000X	Dentist	52654	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437289980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOC Q NGUYEN DDS

Provider Business Mailing Address
First Line	:	9641 WESTWOOD DR
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-6951
Country	:	US
Telephone Number	:	714-702-5599
Fax Number	:

Provider Business Practice Location Address
First Line	:	2150 E SOUTH ST
Second Line	:	SUITE 116
City	:	LONG BEACH
State	:	CA
Zip	:	90805-4457
Country	:	US
Telephone Number	:	562-531-9779
Fax Number	:

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	12/05/2011

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