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NPI Code Detail

MEDICARE: ASHLEY LE NGUYEN

MEDICARE: ASHLEY LE NGUYEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist1002373WI

General Provider Information

NPI Number : 1649888363
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY LE NGUYEN
Provider Business Mailing Address
First Line : 2050 E ALGONQUIN RD STE 610
Second Line :
City : SCHAUMBURG
State : IL
Zip : 60173-4166
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5341 W FOND DU LAC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53216-1365
Country : US
Telephone Number : 847-496-4850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2020
Last Update Date : 07/20/2020

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Directions to “ ASHLEY LE NGUYEN ” Practice Location

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