Healthcare Provider Details

I. General information

NPI: 1023679362
Provider Name (Legal Business Name): VICTORIA NGUYEN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10430 S DE ANZA BLVD STE 185
CUPERTINO CA
95014-3006
US

IV. Provider business mailing address

17 SHARON CT
DALY CITY CA
94014-1567
US

V. Phone/Fax

Practice location:
  • Phone: 408-996-3191
  • Fax:
Mailing address:
  • Phone: 415-967-8949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113186
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: