Provider Demographics
NPI:1336217892
Name:NGUYEN, TAM T (DDS, APC)
Entity Type:Individual
Prefix:DR
First Name:TAM
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS, APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 SILVER CREEK RD STE 180
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1790
Mailing Address - Country:US
Mailing Address - Phone:408-528-8628
Mailing Address - Fax:408-528-9696
Practice Address - Street 1:3005 SILVER CREEK RD STE 180
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1790
Practice Address - Country:US
Practice Address - Phone:408-528-8628
Practice Address - Fax:408-528-9696
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA419731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice