MEDICARE: DUYEN T NGUYEN

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	124Q00000X	Dental Hygienist	RDH31037	CA

General Provider Information

NPI Number	:	1841774932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUYEN T NGUYEN

Provider Business Mailing Address
First Line	:	17361 MELBOURNE LN
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-3832
Country	:	US
Telephone Number	:	714-261-6820
Fax Number	:

Provider Business Practice Location Address
First Line	:	17361 MELBOURNE LN
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-3832
Country	:	US
Telephone Number	:	714-261-6820
Fax Number	:

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

Provider Enumeration Date	:	09/24/2018
Last Update Date	:	09/24/2018

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Directions to “ DUYEN T NGUYEN ” Practice Location

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