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General NPI Number Information
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NPI Number | 1972913374
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Entity Type | Individual
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Provider Name | JULIA NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 7301 MISSION RD STE 317
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208
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Country | US
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Telephone | 913-236-7668
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Fax |
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Provider Business Mailing Address
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Address Line | 9641 N AMBASSADOR DR UNIT 2407
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City | KANSAS CITY
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State | MO
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Zip | 64154-7269
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 019030264
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 2019033972
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 61726
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License Number State | KS
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