Healthcare Provider Details

I. General information

NPI: 1851255053
Provider Name (Legal Business Name): NANCY NGUYEN DMD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 W MONTROSE AVE STE 101
CHICAGO IL
60613-1997
US

IV. Provider business mailing address

5500 N CENTRAL AVE
CHICAGO IL
60630-1307
US

V. Phone/Fax

Practice location:
  • Phone: 773-989-9160
  • Fax:
Mailing address:
  • Phone: 773-459-6965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: NANCY NGUYEN
Title or Position: OWNER
Credential: DMD
Phone: 773-459-6965