Organization · NPI-2

Jimmy Nguyen D.D.S., INC

Preferred Provider Organization · Riverside, CA

NPI number1750797445
StatusActive
Last updated in NPPESJul 2, 2014

Details

NPI
1750797445
Entity type
Organization (NPI-2)
Legal business name
Jimmy Nguyen D.D.S., INC
Organization subpart
No
Enumeration date
Jul 2, 2014
Last updated
Jul 2, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
305R00000X Preferred Provider Organization57891CAYes
302F00000X Exclusive Provider Organization57891CA
302R00000X Health Maintenance Organization57891CA
305S00000X Point of Service57891CA

Other names

  • Melody Dental Care (Doing Business As)

Practice location

7120 Indiana Ave
Suite B
Riverside, CA 92504-4562

Phone 951-276-2877 · Fax 951-276-1124

Mailing address

7120 Indiana Ave
Suite B
Riverside, CA 92504-4562

Phone 951-276-2877 · Fax 951-276-1124

Authorized official

Jimmy Nguyen
President/Dentist
9512762877

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Preferred Provider Organization providers in Riverside, CA