Active NPI
Ngoc My Waite, DDS
- General Practice Dentistry
- Brooklyn Center, MN
National Provider Identifier
1043201353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D10605
- Practice address
- 6300 Shingle Creek Pkwy
Brooklyn Center, MN 55430-2124 - Phone
- (763) 560-4081
- NPI assigned
- Nov 4, 2005
- Sex
- Male
- Sole proprietor
- No
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 | D10605 | MN | Primary |
Addresses
Primary practice location
6300 Shingle Creek Pkwy
Brooklyn Center, MN 55430-2124
Mailing address
6300 Shingle Creek Pkwy
Brooklyn Center, MN 55430-2191
Phone (763) 560-4081
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- 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 |
|---|---|---|---|---|
| I20160115001477 | MN | Order and Referring Only - Dentist | 4486957982 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1043201353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6300 SHINGLE CREEK PKWY",
"city": "BROOKLYN CENTER",
"state": "MN",
"postal_code": "554302191",
"telephone_number": "763-560-4081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6300 SHINGLE CREEK PKWY",
"city": "BROOKLYN CENTER",
"state": "MN",
"postal_code": "554302124",
"telephone_number": "763-560-4081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITE",
"first_name": "NGOC",
"middle_name": "MY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-04",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D10605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn Center, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.