Provider Demographics
NPI:1366517732
Name:NGUYEN, TUAN HOANG (DDS)
Entity type:Individual
Prefix:DR
First Name:TUAN
Middle Name:HOANG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 BERRYESSA RD
Mailing Address - Street 2:SUITE I
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-1309
Mailing Address - Country:US
Mailing Address - Phone:408-254-4567
Mailing Address - Fax:408-254-3567
Practice Address - Street 1:2470 BERRYESSA RD
Practice Address - Street 2:SUITE I
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-1309
Practice Address - Country:US
Practice Address - Phone:408-254-4567
Practice Address - Fax:408-254-3567
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA487561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice