Individual provider Active NPI

Victoria Nguyen, DMD

  • Dentist
  • Cupertino, CA
National Provider Identifier
1023679362
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
113186 Issued in CA
Practice address
10430 S de Anza Blvd Ste 185
Cupertino, CA 95014-3006
Phone
(408) 996-3191
NPI assigned
Jun 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 113186 CA Primary

Addresses

Primary practice location

10430 S de Anza Blvd Ste 185
Cupertino, CA 95014-3006

Mailing address

17 Sharon CT
Daly City, CA 94014-1567
Phone (415) 967-8949

Other practice location 1

39783 Paseo Padre Pkwy
Fremont, CA 94538-2926
Phone (510) 344-6487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190731003002 OH Order and Referring Only - DentistPractitioner - Dentist 3577899335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RES.004102OHMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1023679362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SHARON CT",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940141567",
            "telephone_number": "415-967-8949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10430 S DE ANZA BLVD STE 185",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950143006",
            "telephone_number": "408-996-3191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39783 Paseo Padre Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945382926",
            "country_code": "US",
            "telephone_number": "510-344-6487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VICTORIA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "113186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

Verify at the official NPI Registry.