Individual provider Active NPI

Andino Nguyen, DMD

  • Dentist
  • Port St Lucie, FL
National Provider Identifier
1033041215
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN31653 Issued in FL
Practice address
2729 SE Morningside Blvd
Port St Lucie, FL 34952-5705
Phone
(772) 621-2123
Fax
(772) 291-6744
NPI assigned
Jun 1, 2026
Last updated
Jun 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN31653 FL Primary

Addresses

Primary practice location

2729 SE Morningside Blvd
Port St Lucie, FL 34952-5705

Mailing address

2729 SE Morningside Blvd
Port St Lucie, FL 34952-5705
Phone (772) 621-2123

Other practice location 1

11924 Forest Hill Blvd Ste 10
Wellington, FL 33414-6200
Phone (561) 721-2688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN31653FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
4 No Dental PA Dentist PastSince Nov 6, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1033041215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2729 SE MORNINGSIDE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525705",
            "telephone_number": "772-621-2123",
            "fax_number": "772-291-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2729 SE MORNINGSIDE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525705",
            "telephone_number": "772-621-2123",
            "fax_number": "772-291-6744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11924 Forest Hill Blvd Ste 10",
            "address_purpose": "LOCATION",
            "city": "Wellington",
            "state": "FL",
            "postal_code": "334146200",
            "country_code": "US",
            "telephone_number": "561-721-2688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANDINO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN31653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.