Active NPI
Kathleen Thu Nguyen, D.M.D
- General Practice Dentistry
- Winter Garden, FL
National Provider Identifier
1013143544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN18690
- Practice address
- 13275 W Colonial Dr
Winter Garden, FL 34787-3984 - Phone
- (407) 905-8827
- Fax
- (407) 654-4582
- NPI assigned
- Jun 10, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN18690 | FL | Primary |
Addresses
Primary practice location
13275 W Colonial Dr
Winter Garden, FL 34787-3984
Mailing address
110 S Woodland St
Winter Garden, FL 34787-3546
Phone (407) 905-8827
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001132200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160620002334 | FL | Order and Referring Only - Dentist | 1254622319 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN18690 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445385600000",
"number": "1013143544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 S WOODLAND ST",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347873546",
"telephone_number": "407-905-8827",
"fax_number": "407-654-4582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13275 W COLONIAL DR",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347873984",
"telephone_number": "407-905-8827",
"fax_number": "407-654-4582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KATHLEEN",
"middle_name": "THU",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-10",
"last_updated": "2015-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN18690",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001132200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winter Garden, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.