Provider Demographics
NPI:1275971566
Name:NGUYEN, MELISSA L (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:L
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:L
Other - Last Name:FRENCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:625 NW 54TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-6012
Mailing Address - Country:US
Mailing Address - Phone:405-818-0042
Mailing Address - Fax:
Practice Address - Street 1:711 SW 19TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-2957
Practice Address - Country:US
Practice Address - Phone:405-378-5692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6503122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist