Organization
DOUGLAS NGUYEN, DDS, A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS DUC TIEN NGUYEN DDS (CEO)
(714) 839-9800
Entity
Organization
Contact information
Practice address
9600 BOLSA AVE, SUITE E, WESTMINSTER, CA 92683
(714) 839-9800
(714) 839-9894
Mailing address
9600 BOLSA AVE, SUITE E, WESTMINSTER, CA 92683
(714) 839-9800
(714) 839-9894
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
40970
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
909964
UNITED CONCORDIA PPO DENTAL PROVIDER NUMBER
CA
01
—
B40970-01
DENTI-CAL BILLING PROVIDER NUMBER
CA
01
—
CGP 166519
CALIFORNIA CHILDREN'S SERVICES BILLING PROVIDER
CA
01
—
D40970
DENTI-CAL RENDERING PROVIDER NUMBER
CA
Enumeration date
05/01/2007
Last updated
09/05/2023
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