Active NPI
Kevin Hoang Vuong Nguyen
- Dentist
- Daphne, AL
National Provider Identifier
1104516855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN28911
- Practice address
- 806 Wilson Ave
Daphne, AL 36526-4558 - Phone
- (251) 626-0681
- NPI assigned
- May 8, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D.007194-C1 | AL | |
| Dentist | 122300000X | DN28911 | FL | Primary |
Addresses
Primary practice location
806 Wilson Ave
Daphne, AL 36526-4558
Mailing address
806 Wilson Ave
Daphne, AL 36526-4558
Phone (251) 626-0681
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 |
|---|---|---|---|
| D.007194-C1 | AL | MD | Dentist |
| DN28911 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714435200000",
"number": "1104516855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "806 WILSON AVE",
"city": "DAPHNE",
"state": "AL",
"postal_code": "365264558",
"telephone_number": "251-626-0681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "806 WILSON AVE",
"city": "DAPHNE",
"state": "AL",
"postal_code": "365264558",
"telephone_number": "251-626-0681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KEVIN",
"middle_name": "HOANG VUONG",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-08",
"last_updated": "2024-04-30",
"certification_date": "2024-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AL",
"license": "D.007194-C1",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN28911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daphne, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.