MEDICARE: DR. DE GIAP 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	CA41765	CA

General Provider Information

NPI Number	:	1952311276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DE GIAP NGUYEN DDS

Provider Business Mailing Address
First Line	:	5301 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805
Country	:	US
Telephone Number	:	562-422-7278
Fax Number	:	562-422-3299

Provider Business Practice Location Address
First Line	:	5301 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805
Country	:	US
Telephone Number	:	562-422-7278
Fax Number	:	562-422-3299

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	07/08/2007

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