Provider Demographics
NPI:1033394465
Name:NGUYEN, DANNY TAN (DDS)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:TAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 BERRYESSA RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-1173
Mailing Address - Country:US
Mailing Address - Phone:408-272-4943
Mailing Address - Fax:408-272-2134
Practice Address - Street 1:1725 BERRYESSA RD STE A
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-1173
Practice Address - Country:US
Practice Address - Phone:408-272-4943
Practice Address - Fax:408-272-2134
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA476501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice