Provider Demographics
NPI:1265576896
Name:NGUYEN, TAM THI (DDS)
Entity type:Individual
Prefix:DR
First Name:TAM
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:TAMMY
Other - Middle Name:THI
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5544 MONTEREY HWY.
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-1529
Mailing Address - Country:US
Mailing Address - Phone:408-362-9767
Mailing Address - Fax:408-362-9700
Practice Address - Street 1:5544 MONTEREY HWY.
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95138-1529
Practice Address - Country:US
Practice Address - Phone:408-362-9767
Practice Address - Fax:408-362-9700
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA412001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB41200-02OtherDENTI-CAL
CA902884OtherUNITED CONCORDIA INS.