Ngoc an Khanh Nguyen, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN28478 Issued in FL

Practice address

4021 S Florida Ave
Lakeland, FL 33813-1623

Phone

(863) 837-1087

NPI assigned

Jul 1, 2011

Last updated

Aug 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1053608729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3021 LEILA ESTELLE DR",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335655306",
            "telephone_number": "502-640-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131623",
            "telephone_number": "863-837-1087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2909 James L Redman Pkwy Ste 1",
            "address_purpose": "LOCATION",
            "city": "Plant City",
            "state": "FL",
            "postal_code": "335669404",
            "country_code": "US",
            "telephone_number": "813-577-4996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "NGOC AN",
        "middle_name": "KHANH",
        "name_prefix": "Ms.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9082",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN28478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anh Nguyen
• Anita Nguyen, OD
• Ayden Nguyen
• Co Tran Nhuan Nguyen, DO
• Dylan Nguyen
• Ngoc Thi Nguyen, MD
• Quyen Tong Nha Nguyen
• Shon Nguyen, RDN
• Toan Thien Nguyen, M.D.
• Nic 5 Lake Morton Plaza Leasing LLC (Lake Morton Plaza)

• General Practice Dentistry in Lakeland, FL
• Providers in Lakeland, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.