Active NPI
Dzung B. Nguyen, DMD
- General Practice Dentistry
- Deland, FL
National Provider Identifier
1093775280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN14906
- Practice address
- 2641 S Woodland Blvd
Deland, FL 32720-8601 - Phone
- (386) 738-7441
- Fax
- (386) 738-1299
- NPI assigned
- Mar 23, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN14906 | FL | Primary |
Addresses
Primary practice location
2641 S Woodland Blvd
Deland, FL 32720-8601
Mailing address
926 Great Pond Dr
Suite 2003
Altamonte Springs, FL 32714-7244
Phone (407) 772-5124
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001039300 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20150619001188 | FL | Order and Referring Only - Dentist | 1658682414 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN14906 | FL | MD | General Practice Dentistry |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272240000000",
"number": "1093775280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "926 GREAT POND DR",
"address_2": "SUITE 2003",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327147244",
"telephone_number": "407-772-5124",
"fax_number": "407-788-3572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2641 S WOODLAND BLVD",
"city": "DELAND",
"state": "FL",
"postal_code": "327208601",
"telephone_number": "386-738-7441",
"fax_number": "386-738-1299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "DZUNG",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-23",
"last_updated": "2010-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN14906",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001039300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Deland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; 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.