MEDICARE: CHRISTIAN HOAI NGUYEN DDS INC .

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	47649	CA

General Provider Information

NPI Number	:	1467677401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIAN HOAI NGUYEN DDS INC .

Provider Business Mailing Address
First Line	:	750 S WINCHESTER BLVD
Second Line	:	SUITE # D
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2927
Country	:	US
Telephone Number	:	408-261-8585
Fax Number	:	408-261-8585

Provider Business Practice Location Address
First Line	:	750 S WINCHESTER BLVD
Second Line	:	SUITE # D
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2927
Country	:	US
Telephone Number	:	408-261-8585
Fax Number	:	408-261-8585

Authorized Official
Title or Position	:	CEO PRESEIDENT
Name	:	DR. CHRISTIAN HOAI NGUYEN
Credential	:	DDS
Telephone Number	:	408-261-8585

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	08/22/2020

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