Individual provider Active NPI

Tin Nguyen, DMD

  • Dentist
  • Orange, CA
National Provider Identifier
1053635813
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
58994 Issued in CA
Practice address
530 S Main St
Orange, CA 92868-4525
Phone
(714) 571-2186
Fax
(714) 571-3688
NPI assigned
Mar 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 58994 CA Primary

Addresses

Primary practice location

530 S Main St
Orange, CA 92868-4525

Mailing address

530 S Main St
Orange, CA 92868-4525
Phone (714) 571-2186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260309000516 CA Practitioner - Dentist 9537642533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

335 E Ave I
Lancaster, CA 93535-1916

5850 S Main St
FL 2
Los Angeles, CA 90003-1215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58994CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Dec 24, 2025 Accepting new patients
County of Los Angeles CurrentSince Dec 24, 2025 Accepting new patients

Locations

5850 S Main St
Los Angeles, CA 90003
Phone (323) 846-4312

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1053635813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684525",
            "telephone_number": "714-571-2186",
            "fax_number": "714-571-3688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684525",
            "telephone_number": "714-571-2186",
            "fax_number": "714-571-3688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-23",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.