Provider Demographics
NPI:1861603870
Name:MINH B. NGUYEN, DDS
Entity type:Organization
Organization Name:MINH B. NGUYEN, DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MINH
Authorized Official - Middle Name:B
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-435-1155
Mailing Address - Street 1:2221 SUNSET BLVD STE 119
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-4784
Mailing Address - Country:US
Mailing Address - Phone:916-435-1155
Mailing Address - Fax:916-435-1152
Practice Address - Street 1:2221 SUNSET BLVD STE 119
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-4784
Practice Address - Country:US
Practice Address - Phone:916-435-1155
Practice Address - Fax:916-435-1152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45506122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty