Michael Nguyen, DMD
Individual provider Active NPI General Practice Dentistry · Park City, IL
NPI 1457024028 · NPPES record last updated Jul 29, 2021
Key facts
- NPI
- 1457024028
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 019.033090 (IL)
- Practice address
- 355 S Greenleaf Ave
Ste E
Park City, IL 60085 - Phone
- (847) 457-0195
- NPI assigned
- Jul 29, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.033090 | IL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.033090 | IL | Yes |
Addresses
Primary practice location
355 S Greenleaf Ave
Ste E
Park City, IL 60085
Mailing address
1269 Mallard LN
Hoffman Estates, IL 60192-4507
Phone (312) 335-9188
Other providers in Park City, IL
- Sophie Lafayette
- Lake Shore Dermatology, LTD.
- Sheila Varghese Maliekel
- Milagros Galvez DDS PC
- David R. Mortensen
- North Shore Urogynecology LTD
- Omnidoc Health Inc
- Rhutav J Parikh
- Podiatry & Sports Medicine Associates P.C.
- Peter Joseph Puthenveetil
All providers in Park City, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.