Provider Demographics
NPI:1669686309
Name:NGUYEN, HIEN TAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:HIEN
Middle Name:TAM
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3087 MCKEE RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-1835
Mailing Address - Country:US
Mailing Address - Phone:408-347-1773
Mailing Address - Fax:408-347-1811
Practice Address - Street 1:3087 MCKEE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-1835
Practice Address - Country:US
Practice Address - Phone:408-347-1773
Practice Address - Fax:408-347-1811
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53020122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist