Healthcare Provider Details

I. General information

NPI: 1063367878
Provider Name (Legal Business Name): TIMOTHY THOAI NGUYEN DDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

991 MONTAGUE EXPRESSWAY, SUITE 102
MILPITAS CA
95035
US

IV. Provider business mailing address

991 MONTAGUE EXPRESSWAY, SUITE 102
MILPITAS CA
95035
US

V. Phone/Fax

Practice location:
  • Phone: 408-946-6666
  • Fax: 669-900-4289
Mailing address:
  • Phone: 408-946-6666
  • Fax: 669-900-4289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY THOAI NGUYEN
Title or Position: ORAL AND MAXILLOFACIAL SURGEON
Credential: D.D.S.
Phone: 408-946-6666