Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 104660 | CA |
NPI | 1063023844 |
---|---|
Provider Name | Dr. Mychi Nguyen |
First Address | New York, NY 10009-3007 |
Second Address | Oklahoma City, OK 73134-6003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2020 |
Last Update Date | 13/08/2020 |