Active NPI
Tri Minh Nguyen, DMD
- Dentist
- Colorado Springs, CO
National Provider Identifier
1043903537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 00205623
- Practice address
- 5198 N Nevada Ave Ste 100
Colorado Springs, CO 80918-8649 - Phone
- (719) 634-8884
- NPI assigned
- May 31, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 00205623 | CO | Primary |
Addresses
Primary practice location
5198 N Nevada Ave Ste 100
Colorado Springs, CO 80918-8649
Mailing address
1110 Medley GRV Apt 203
Colorado Springs, CO 80921-4522
Phone (206) 612-4418
Other practice location 1
6940 Mesa Ridge Pkwy
Fountain, CO 80817-1533
Phone (719) 382-4936
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- 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 |
|---|---|---|---|---|
| I20231020001917 | CO | Order and Referring Only - Dentist | 5294181608 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00205623 | CO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Springs Modern Dentistry, LLP | Past | Accepting new patients | |
| Fountain Modern Dentistry and Orthodontics, LLP | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Colorado Springs, CO
- NPI 1700116589
-
- General Practice Dentistry
- Irvine, CA
- NPI 1730434622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1043903537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 MEDLEY GRV APT 203",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809214522",
"telephone_number": "206-612-4418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5198 N NEVADA AVE STE 100",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809188649",
"telephone_number": "719-634-8884"
}
],
"practiceLocations": [
{
"address_1": "6940 Mesa Ridge Pkwy",
"address_purpose": "LOCATION",
"city": "Fountain",
"state": "CO",
"postal_code": "808171533",
"country_code": "US",
"telephone_number": "719-382-4936",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "TRI",
"middle_name": "MINH",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-31",
"last_updated": "2023-05-31",
"certification_date": "2023-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "00205623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.