# SAN JOSE DENTAL SURGERY CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902086606
- **Authorized official:** KHAM NGUYEN DDS (VICE PRESIDENT)
- **Authorized official phone:** (408) 240-9000

## Contact information

- **Practice address:** 2048 STORY RD, SAN JOSE, CA 95122-1668
- **Practice address phone:** (408) 240-9000
- **Mailing address:** 2048 STORY RD, SAN JOSE, CA 95122-1668
- **Mailing address phone:** (408) 240-9000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | D52747 | CA | Yes |
| 261QD0000X | Dental Clinic/Center | D52747 | CA | — |

## Other

- **Enumeration date:** 11/09/2007
- **Last updated:** 04/05/2025