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General NPI Number Information
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NPI Number | 1962545509
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Entity Type | Individual
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Provider Name | DANA NGUYEN SCHMIDL DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 2937 SISKIYOU BLVD STE 2
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City | MEDFORD
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State | OR
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Zip | 97504-8100
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Country | US
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Telephone | 541-773-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 412 W VENETO CIR
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City | MEDFORD
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State | OR
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Zip | 97504-3625
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Country | US
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Telephone | 909-215-9870
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D10375
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License Number State | OR
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