MEDICARE: HOUSTON 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	122300000X	Dentist	59254	CA

General Provider Information

NPI Number	:	1801286323
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON NGUYEN, DDS, INC

Provider Business Mailing Address
First Line	:	1654 E CAPITOL EXPY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1839
Country	:	US
Telephone Number	:	408-238-1806
Fax Number	:	408-238-1877

Provider Business Practice Location Address
First Line	:	1654 E CAPITOL EXPY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1839
Country	:	US
Telephone Number	:	408-238-1806
Fax Number	:	408-238-1877

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HOUSTON NGUYEN
Credential	:	DDS
Telephone Number	:	408-238-1806

Provider Enumeration Date	:	02/04/2015
Last Update Date	:	02/04/2015

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