Provider Demographics
NPI:1053656553
Name:NAGEL, NORMAN JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:JOHN
Last Name:NAGEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3695 ALAMO ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-2188
Mailing Address - Country:US
Mailing Address - Phone:805-581-2480
Mailing Address - Fax:805-581-4652
Practice Address - Street 1:3695 ALAMO ST
Practice Address - Street 2:SUITE 301
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2188
Practice Address - Country:US
Practice Address - Phone:805-581-2480
Practice Address - Fax:805-581-4652
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA209161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics