Healthcare Provider Details

I. General information

NPI: 1235943945
Provider Name (Legal Business Name): DUY NGUYEN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5433 ROBERTS ST
SHAWNEE KS
66226-3937
US

IV. Provider business mailing address

5433 ROBERTS ST
SHAWNEE KS
66226-3937
US

V. Phone/Fax

Practice location:
  • Phone: 913-422-5200
  • Fax:
Mailing address:
  • Phone: 913-422-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2026028149
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: