Provider Demographics
NPI:1780996405
Name:NGUYEN, AMY K (DDS)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:K
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 1:1429 GRANT RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-3250
Mailing Address - Country:US
Mailing Address - Phone:650-967-9900
Mailing Address - Fax:650-967-9909
Practice Address - Street 1:1429 GRANT RD
Practice Address - Street 2:SUITE B
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-3250
Practice Address - Country:US
Practice Address - Phone:650-967-9900
Practice Address - Fax:650-967-9909
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA606191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice