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General NPI Number Information
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NPI Number | 1013646165
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Entity Type | Individual
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Provider Name | KAYLIE MY NGUYEN DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 06/06/2022
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 3105 LIMESTONE RD STE 203
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City | WILMINGTON
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State | DE
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Zip | 19808-2151
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Country | US
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Telephone | 302-995-6979
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Fax |
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Provider Business Mailing Address
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Address Line | 2 CRABAPPLE CT
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City | NEWARK
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State | DE
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Zip | 19702-3945
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Country | US
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Telephone | 301-503-7086
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 17482
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | G1-0011609
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License Number State | DE
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