Provider Demographics
NPI:1831707108
Name:NGUYENFA, TIFFANY (DDS)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:NGUYENFA
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 MISSION ST STE 330
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2487
Mailing Address - Country:US
Mailing Address - Phone:714-457-8996
Mailing Address - Fax:
Practice Address - Street 1:2480 MISSION ST STE 330
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2487
Practice Address - Country:US
Practice Address - Phone:714-457-8996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1050521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice