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NPI Code Detail

MEDICARE: KATHLEEN NGUYEN DMD

MEDICARE: KATHLEEN NGUYEN 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
1122300000XDentistD011848AZ

General Provider Information

NPI Number : 1881370005
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN NGUYEN DMD
Provider Business Mailing Address
First Line : 6659 W MONONA DR
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-6650
Country : US
Telephone Number : 408-600-9344
Fax Number :
Provider Business Practice Location Address
First Line : 14858 N FRANK LLOYD WRIGHT BLVD STE 165A
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85260-2216
Country : US
Telephone Number : 480-860-4455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2023
Last Update Date : 06/22/2023

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Directions to “ KATHLEEN NGUYEN DMD” Practice Location

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