Provider Demographics
NPI:1790231405
Name:NGUYEN SEID, NAM MICHELLE (DDS)
Entity type:Individual
Prefix:DR
First Name:NAM MICHELLE
Middle Name:
Last Name:NGUYEN SEID
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:N MICHELLE
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:22341 WEST RD
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48183
Mailing Address - Country:US
Mailing Address - Phone:734-671-1620
Mailing Address - Fax:734-671-2154
Practice Address - Street 1:22341 WEST RD
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:MI
Practice Address - Zip Code:48183
Practice Address - Country:US
Practice Address - Phone:734-671-1620
Practice Address - Fax:734-671-2154
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315078450122300000X
MI2901022041122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist