MEDICARE: NGUYEN OAKLEY DENTAL GROUP PC. INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1285399592
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NGUYEN OAKLEY DENTAL GROUP PC. INC

Provider Business Mailing Address
First Line	:	PO BOX 920050
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75392-0050
Country	:	US
Telephone Number	:	714-845-8890
Fax Number	:	303-952-0892

Provider Business Practice Location Address
First Line	:	3263 VANDERCAR WAY
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-7545
Country	:	US
Telephone Number	:	513-978-5868
Fax Number	:	513-978-5618

Authorized Official
Title or Position	:	OWNER DOCTOR
Name	:	BACH NGUYEN
Credential	:	DDS
Telephone Number	:	513-978-5868

Provider Enumeration Date	:	11/02/2021
Last Update Date	:	11/02/2021

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