Healthcare Provider Details

I. General information

NPI: 1134035322
Provider Name (Legal Business Name): NAING GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 N COLISEUM BLVD
FORT WAYNE IN
46805-5526
US

IV. Provider business mailing address

1229 EATON DR
SOUTH BEND IN
46614-2137
US

V. Phone/Fax

Practice location:
  • Phone: 574-401-8142
  • Fax: 574-401-8143
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: KYAW NAING
Title or Position: DOCTOR/OWNER
Credential: OD
Phone: 574-401-8142