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General NPI Number Information
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NPI Number | 1760187819
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Entity Type | Individual
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Provider Name | MICHELLE NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 03/30/2023
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 306 CENTER DR
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City | SUPERIOR
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State | CO
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Zip | 80027-8625
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Country | US
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Telephone | 303-499-9555
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Fax |
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Provider Business Mailing Address
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Address Line | 1040 SANTA FE DR APT 1-503
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City | DENVER
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State | CO
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Zip | 80204-4354
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Country | US
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Telephone | 520-789-4636
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DEN.00206378
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License Number State | CO
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