MEDICARE: DR. HOUSTON NGUYEN DDS

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	019-026838	IL

General Provider Information

NPI Number	:	1992791594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOUSTON NGUYEN DDS

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	:

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	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	01/19/2022

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