Provider Demographics
NPI:1144220476
Name:NGUYEN, LINDA MINH (DDS)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MINH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3433
Mailing Address - Country:US
Mailing Address - Phone:626-281-6642
Mailing Address - Fax:626-281-0152
Practice Address - Street 1:407 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3433
Practice Address - Country:US
Practice Address - Phone:626-281-6642
Practice Address - Fax:626-281-0152
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA453971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93060-01OtherDENTI-CAL