# JACK NGUYEN, DDS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285111617
- **Authorized official:** DR. JACK NGUYEN DDS (DOCTOR/OWNER)
- **Authorized official phone:** (310) 710-9960

## Contact information

- **Practice address:** 2654 W HORIZON RIDGE PKWY STE B5-346, HENDERSON, NV 89052-2803
- **Practice address phone:** (310) 710-9960
- **Mailing address:** 2654 W HORIZON RIDGE PKWY STE B5-346, HENDERSON, NV 89052-2803
- **Mailing address phone:** (310) 710-9960

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 07/27/2018
- **Last updated:** 07/27/2018