Provider Demographics
NPI:1053020693
Name:CHRISTINE NGUYEN CABRERA DDS INC
Entity type:Organization
Organization Name:CHRISTINE NGUYEN CABRERA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:NGUYEN
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-856-4288
Mailing Address - Street 1:16425 HARBOR BLVD APT 181
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-8307
Mailing Address - Country:US
Mailing Address - Phone:714-856-4288
Mailing Address - Fax:
Practice Address - Street 1:1922 S GAREY AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-5724
Practice Address - Country:US
Practice Address - Phone:714-856-4288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty