Organization Active NPI

Colleen Nguyen, D.D.S., P.a.

  • Dentist
  • Kansas City, KS
National Provider Identifier
1033579107
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7141 Issued in KS
Legal business name
COLLEEN NGUYEN, D.D.S., P.A.
Practice address
9501 State Ave Ste 7
Kansas City, KS 66111-1871
Phone
(913) 788-0800
Fax
(913) 788-4390
NPI assigned
Mar 2, 2016
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Dr. Colleen Nguyen, DDSNPI 1669447520
Title
Owner
Phone
(913) 788-0800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 7141 KS Primary
Durable Medical Equipment & Medical Supplies 332B00000X 7141 KS

Addresses

Primary practice location

9501 State Ave Ste 7
Kansas City, KS 66111-1871

Mailing address

9501 State Ave
Suite 7
Kansas City, KS 66111-1871
Phone (913) 788-0800

Other practice location 1

9501 State Ave
Suite 7
Kansas City, KS 66111-1872
Phone (913) 788-0800

Other identifiers 1

IdentifierTypeStateIssuer
7551110001OtherKSPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160915002722 KS DME Supplier - Oral Surgery - Dentist 0648566711 Practice locations: Kansas City, KS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1033579107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 STATE AVE",
            "address_2": "SUITE 7",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661111871",
            "telephone_number": "913-788-0800",
            "fax_number": "913-788-4390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 STATE AVE STE 7",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661111871",
            "telephone_number": "913-788-0800",
            "fax_number": "913-788-4390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9501 State Ave",
            "address_2": "Suite 7",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661111872",
            "country_code": "US",
            "telephone_number": "913-788-0800",
            "fax_number": "913-788-4390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLLEEN NGUYEN, D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-788-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "KS",
            "license": "7141",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KS",
            "license": "7141",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "7551110001",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.