Provider Demographics
NPI:1700314317
Name:NGUYEN, LYNN MY (DDS)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:MY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MY-LYNN
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2220 SW 33RD ST
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73170-4542
Mailing Address - Country:US
Mailing Address - Phone:505-204-5677
Mailing Address - Fax:
Practice Address - Street 1:2620 NW EXPRESSWAY STE E
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7207
Practice Address - Country:US
Practice Address - Phone:405-943-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK62991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice