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NPI Code Detail

MEDICARE: DR. MISEANNE NGUYEN TANG DMD

MEDICARE:  DR. MISEANNE NGUYEN TANG  DMD
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
11223G0001XGeneral Practice DentistryDN25865FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DN25865OTHERFLDENTAL LICENSE NUMBER

General Provider Information

NPI Number : 1780250589
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MISEANNE NGUYEN TANG DMD
Provider Business Mailing Address
First Line : 8568 PELICAN LN
Second Line :
City : SEMINOLE
State : FL
Zip : 33777-3446
Country : US
Telephone Number : 727-254-0623
Fax Number :
Provider Business Practice Location Address
First Line : 4240 W KENNEDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33609-2231
Country : US
Telephone Number : 813-636-9400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2021
Last Update Date : 06/02/2021

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Directions to “ DR. MISEANNE NGUYEN TANG DMD” Practice Location

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