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General NPI Number Information
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NPI Number | 1720101157
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Entity Type | Organization
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Legal Business Name | MAI HUONG NGUYEN, DDS, APC
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1657 MCKEE RD STE 40
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City | SAN JOSE
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State | CA
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Zip | 95116-1209
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Country | US
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Telephone | 408-937-9229
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Fax | 408-937-6169
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Provider Business Mailing Address
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Address Line | 1657 MCKEE RD STE 40
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City | SAN JOSE
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State | CA
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Zip | 95116-1209
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Country | US
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Telephone | 408-937-9229
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Fax | 408-937-6169
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MAI HUONG NGUYEN
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Credential | DDS
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Telephone | 408-937-9229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 44519
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License Number State | CA
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