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1692 TULLY DENTISTRY
NPI 1649406133
Dentist in San Jose, CA

Active since June 10, 2009
2114 SENIOR ROAD, SUITE 25, SAN JOSE, CA 95112(408) 279-2114(408) 279-1828 Get Directions Write a Review

NPPES record last updated: June 10, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About 1692 Tully Dentistry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

1692 TULLY DENTISTRY (NPI 1649406133) is a healthcare organization registered as a dentist in San Jose, California and active in the NPI registry since June 2009. The organization lists Phung Kim Nguyen, Dentist, as its authorized official.

NPPES Registry Identity

NPI1649406133
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business Name1692 TULLY DENTISTRY
Location Address2114 SENIOR ROAD, SUITE 25San Jose, CA 95112
Mailing Address1692 Tully Road, #4San Jose, CA 95122 · (408) 223-6953 · Fax (408) 223-0749
Phone(408) 279-2114
Fax(408) 279-1828
Organization SubpartNo
Authorized OfficialPhung Kim NguyenDentist · (408) 279-2114
Enumeration DateJune 10, 2009
✔ NPI 1649406133 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · 44749
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
2114 SENIOR ROAD, San Jose, CA 95112
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 1692 Tully Dentistry's NPI number?

The NPI number for 1692 Tully Dentistry is 1649406133. It was assigned to this organization in the NPPES registry on June 10, 2009.

Where is 1692 Tully Dentistry located?

1692 Tully Dentistry is located at 2114 Senior Road Suite 25, San Jose, CA 95112. The listed phone number is (408) 279-2114.

What is 1692 Tully Dentistry's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for 1692 Tully Dentistry was last updated on June 10, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.