Provider Demographics
NPI:1033835681
Name:NGUYEN, MICHELLE LANDAI (DDS)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LANDAI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 CARRIAGE HOUSE DR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-2041
Mailing Address - Country:US
Mailing Address - Phone:626-836-7578
Mailing Address - Fax:
Practice Address - Street 1:3944 PECK RD STE 2
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-2200
Practice Address - Country:US
Practice Address - Phone:626-401-9338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1082191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice