Provider Demographics
NPI:1851611495
Name:NGUYEN, MAI THUY (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAI
Middle Name:THUY
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 1:5512 NEW HARBOR CT
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-5191
Mailing Address - Country:US
Mailing Address - Phone:415-310-8465
Mailing Address - Fax:
Practice Address - Street 1:500 LAWRENCE EXPY
Practice Address - Street 2:SUITE D
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4029
Practice Address - Country:US
Practice Address - Phone:408-720-0322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-06
Last Update Date:2010-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50171122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist