Individual provider Active NPI

Linh Nguyen

  • General Practice Dentistry
  • Battle Ground, WA
National Provider Identifier
1093595977
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61482212 Issued in WA
Practice address
1214 SW Scotton Way
Battle Ground, WA 98604-2715
Phone
(360) 843-2001
NPI assigned
Sep 29, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61482212 WA Primary

Addresses

Primary practice location

1214 SW Scotton Way
Battle Ground, WA 98604-2715

Mailing address

12412 Lake City Blvd SW
Tacoma, WA 98498-4206
Phone (703) 628-4775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240201000498 WA Order and Referring Only - DentistPractitioner - Dentist 5496108813

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61482212WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1093595977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12412 LAKE CITY BLVD SW",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984984206",
            "telephone_number": "703-628-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 SW SCOTTON WAY",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986042715",
            "telephone_number": "360-843-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LINH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-29",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "61482212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Ground, WA

Sources for this page

Verify at the official NPI Registry.