NPIMap

Organization Active NPI

Jonathan C. Nguyen, DDS, Inc.

  • Dentist
  • San Diego, CA
National Provider Identifier
1104034982
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
51099 Issued in CA
Legal business name
JONATHAN C. NGUYEN, DDS, INC.
Practice address
4575 El Cajon Blvd Ste a
San Diego, CA 92115-4390
Phone
(619) 281-5569
Fax
(619) 281-5559
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Authorized official

Name
Jonathan Chuong Le Nguyen, D.D.SNPI 1508971201
Title
Dentist
Phone
(619) 281-5569

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 51099 CA Primary

Addresses

Primary practice location

4575 El Cajon Blvd Ste a
San Diego, CA 92115-4390

Mailing address

4575 El Cajon Blvd Ste a
San Diego, CA 92115-4390
Phone (619) 281-5569

Other identifiers 1

IdentifierTypeStateIssuer
G9289201OtherCADENTICAL BILLING NUMBER

Other names 1

  • None Doing business as

National Provider Directory

National Provider Directory

Locations

4575 El Cajon Blvd
Ste A
San Diego, CA 92115
Phone (619) 281-5569

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1104034982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4575 EL CAJON BLVD STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154390",
            "telephone_number": "619-281-5569",
            "fax_number": "619-281-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4575 EL CAJON BLVD STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154390",
            "telephone_number": "619-281-5569",
            "fax_number": "619-281-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN C. NGUYEN, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "CHUONG LE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "619-281-5569",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "51099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL BILLING NUMBER",
            "identifier": "G9289201",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

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

Verify at the official NPI Registry.