Provider Demographics
NPI:1831302975
Name:NGUYEN, TRAM THUY (DMD)
Entity Type:Individual
Prefix:
First Name:TRAM
Middle Name:THUY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 S KING RD
Mailing Address - Street 2:STE 10
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-4408
Mailing Address - Country:US
Mailing Address - Phone:408-223-2990
Mailing Address - Fax:408-223-2959
Practice Address - Street 1:2435 S KING RD STE 10
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-4408
Practice Address - Country:US
Practice Address - Phone:408-223-2990
Practice Address - Fax:408-223-2959
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA471441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice