Provider Demographics
NPI:1194212464
Name:THAO MINH NGUYEN, DDS, INC
Entity Type:Organization
Organization Name:THAO MINH NGUYEN, DDS, INC
Other - Org Name:SMILEWORLD DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THAO
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-258-5555
Mailing Address - Street 1:2811 STORY RD STE 50
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-3924
Mailing Address - Country:US
Mailing Address - Phone:408-929-9797
Mailing Address - Fax:
Practice Address - Street 1:2811 STORY RD STE 50
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-3924
Practice Address - Country:US
Practice Address - Phone:408-929-9797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-22
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental