Provider Demographics
NPI:1013515535
Name:NGUYEN, SHEILA T (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MILL ST STE 104
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4738
Mailing Address - Country:US
Mailing Address - Phone:781-648-0279
Mailing Address - Fax:781-641-3143
Practice Address - Street 1:22 MILL ST STE 104
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4738
Practice Address - Country:US
Practice Address - Phone:781-648-0279
Practice Address - Fax:781-641-3143
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1858854122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist