Provider Demographics
NPI:1306489364
Name:NATALIE NGUYEN DDS PLLC
Entity type:Organization
Organization Name:NATALIE NGUYEN DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:CASPERS
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-923-6127
Mailing Address - Street 1:3420 PARK SOUTH STATION BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-4465
Mailing Address - Country:US
Mailing Address - Phone:919-923-6127
Mailing Address - Fax:
Practice Address - Street 1:15060 IDLEWILD RD STE F
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-3603
Practice Address - Country:US
Practice Address - Phone:919-923-6127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental