| Woodbridge Dentistry | |
|
4950 Barranca Pkwy Suite 309 Irvine CA 92604 | |
| (949) 552-5055 | |
| (949) 552-6613 |
| Full Name | Woodbridge Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 4950 Barranca Pkwy, Irvine, California |
| Authorized Official Name and Position | Thuy-anh Pham Nguyen (PRESIDENT) |
| Authorized Official Contact | 9493035475 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodbridge Dentistry 4950 Barranca Pkwy Suite 309 Irvine CA 92604-4671 Ph: (949) 552-5055 | Woodbridge Dentistry 4950 Barranca Pkwy Suite 309 Irvine CA 92604 Ph: (949) 552-5055 |
| NPI Number | 1306113089 |
|---|---|
| Provider Enumeration Date | 11/22/2011 |
| Last Update Date | 06/14/2018 |
| Medicare PECOS PAC ID | 1456606151 |
|---|---|
| Medicare Enrollment ID | O20180621000449 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306113089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 47140 (California) | Primary |
| Provider Name | Thuy-anh P Nguyen |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1346485752 PECOS PAC ID: 0345595047 Enrollment ID: I20180621000624 |
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