Active NPI
Marie Nguyen
- Dentist
- West Covina, CA
National Provider Identifier
1093192817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 51822
- Practice address
- 19046 La Puente Rd
West Covina, CA 91792-2832 - Phone
- (626) 965-8310
- NPI assigned
- Apr 30, 2015
- Last updated
- Apr 30, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 51822 | CA | Primary |
| Dentist | 122300000X | 16921 | TX |
Addresses
Primary practice location
19046 La Puente Rd
West Covina, CA 91792-2832
Mailing address
819 N Santa Anita Ave
Arcadia, CA 91006-2327
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16921 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430352000000",
"number": "1093192817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "819 N SANTA ANITA AVE",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910062327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19046 LA PUENTE RD",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917922832",
"telephone_number": "626-965-8310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-30",
"last_updated": "2015-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "51822",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "16921",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.