| Tan Nghiem Dds, Inc | |
|
12132 Brookhurst St Garden Grove CA 92840-2817 | |
| (714) 638-7111 | |
| Not Available |
| Full Name | Tan Nghiem Dds, Inc |
|---|---|
| Speciality | Dentist |
| Location | 12132 Brookhurst St, Garden Grove, California |
| Authorized Official Name and Position | Tan Trung Nghiem (PRESIDENT) |
| Authorized Official Contact | 7148009483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tan Nghiem Dds, Inc 12132 Brookhurst St Garden Grove CA 92840-2817 Ph: (714) 638-7111 | Tan Nghiem Dds, Inc 12132 Brookhurst St Garden Grove CA 92840-2817 Ph: (714) 638-7111 |
| NPI Number | 1760780910 |
|---|---|
| Provider Enumeration Date | 03/11/2011 |
| Last Update Date | 03/11/2011 |
| Medicare PECOS PAC ID | 7810248747 |
|---|---|
| Medicare Enrollment ID | O20180917000119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760780910 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 57467 (California) | Primary |
| Provider Name | Glenn Chang |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1114191251 PECOS PAC ID: 4082835269 Enrollment ID: I20141103000762 |
| Provider Name | Tan Trung Nghiem |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1164679379 PECOS PAC ID: 8729339650 Enrollment ID: I20180917000159 |
| Provider Name | Raffie Garabedian |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1841710316 PECOS PAC ID: 3274954904 Enrollment ID: I20200604000443 |
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