Provider Demographics
NPI:1720101157
Name:MAI HUONG NGUYEN, DDS, APC
Entity Type:Organization
Organization Name:MAI HUONG NGUYEN, DDS, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAI
Authorized Official - Middle Name:HUONG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-937-9229
Mailing Address - Street 1:1657 MCKEE RD STE 40
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1209
Mailing Address - Country:US
Mailing Address - Phone:408-937-9229
Mailing Address - Fax:408-937-6169
Practice Address - Street 1:1657 MCKEE RD STE 40
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1209
Practice Address - Country:US
Practice Address - Phone:408-937-9229
Practice Address - Fax:408-937-6169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44519122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty