Healthcare Provider Details

I. General information

NPI: 1962993899
Provider Name (Legal Business Name): MINDY VU NGUYEN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2018
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 PLEASANT ST STE 102-103
FALL RIVER MA
02723-1000
US

IV. Provider business mailing address

933 PLEASANT ST STE 102-103
FALL RIVER MA
02723-1000
US

V. Phone/Fax

Practice location:
  • Phone: 774-271-5936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number060567
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN10000764
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: