Provider Demographics
NPI:1174623615
Name:NGUYEN, JAIME A (DDS)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:A
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 1:9871 CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-2710
Mailing Address - Country:US
Mailing Address - Phone:714-534-7290
Mailing Address - Fax:714-534-7542
Practice Address - Street 1:9871 CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-2710
Practice Address - Country:US
Practice Address - Phone:714-534-7290
Practice Address - Fax:714-534-7542
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA473961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice