Provider Demographics
NPI:1811774755
Name:TIFFANY H NGUYEN, INC, DDS
Entity type:Organization
Organization Name:TIFFANY H NGUYEN, INC, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:H
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-332-7954
Mailing Address - Street 1:355 BERRY ST APT 340
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-1573
Mailing Address - Country:US
Mailing Address - Phone:408-332-7954
Mailing Address - Fax:
Practice Address - Street 1:26 W PORTAL AVE STE 4
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1343
Practice Address - Country:US
Practice Address - Phone:408-332-7954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental