Provider Demographics
NPI:1962545509
Name:SCHMIDL, DANA NGUYEN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:NGUYEN
Last Name:SCHMIDL
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:MS
Other - First Name:DANG
Other - Middle Name:HANH-THAI
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:412 W VENETO CIR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-3625
Mailing Address - Country:US
Mailing Address - Phone:909-215-9870
Mailing Address - Fax:
Practice Address - Street 1:2937 SISKIYOU BLVD STE 2
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8100
Practice Address - Country:US
Practice Address - Phone:541-773-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD103751223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics