Provider Demographics
NPI:1992863211
Name:SAN JOSE DENTAL CARE
Entity Type:Organization
Organization Name:SAN JOSE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM HUY
Authorized Official - Middle Name:QUANG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-998-8866
Mailing Address - Street 1:345 E SANTA CLARA ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95113-1933
Mailing Address - Country:US
Mailing Address - Phone:408-998-8866
Mailing Address - Fax:408-998-8857
Practice Address - Street 1:345 E SANTA CLARA ST STE 102
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95113-1933
Practice Address - Country:US
Practice Address - Phone:408-998-8866
Practice Address - Fax:408-998-8857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47538122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty