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General NPI Number Information
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NPI Number | 1962993899
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Entity Type | Individual
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Provider Name | MINDY VU NGUYEN DMD
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Gender | Female
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Dates
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Enumeration Date | 05/26/2018
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 388 PARK AVE
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City | WORCESTER
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State | MA
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Zip | 01610-1025
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Country | US
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Telephone | 508-861-2258
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Fax |
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Provider Business Mailing Address
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Address Line | 388 PARK AVE
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City | WORCESTER
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State | MA
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Zip | 01610-1025
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 060567
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN10000764
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License Number State | MA
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