Individual provider Active NPI

Tangwan Nganteh, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Arnold, MO
National Provider Identifier
1104519362
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2025030771 Issued in MO
Practice address
2231 Michigan Ave
Arnold, MO 63010-2151
Phone
(636) 287-6603
NPI assigned
Jun 1, 2023
Last updated
Dec 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DEN2000285 DC
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2025030771 MO Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

2231 Michigan Ave
Arnold, MO 63010-2151

Mailing address

1 Cardinal Way
Saint Louis, MO 63102-2806

Other practice location 1

3521 12th St NE
Washington, DC 20017-2545
Phone (202) 450-5929

Other practice location 2

2900 14th St NW
Washington, DC 20009-6863
Phone (202) 847-0567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20260408000424 MO Order and Referring Only - DentistPractitioner - Dentist 5698240638

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN2000285DCMDGeneral Practice Dentistry
2025030771MOMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1104519362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CARDINAL WAY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631022806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 MICHIGAN AVE",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630102151",
            "telephone_number": "636-287-6603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3521 12th St NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200172545",
            "country_code": "US",
            "telephone_number": "202-450-5929",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 14th St NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200096863",
            "country_code": "US",
            "telephone_number": "202-847-0567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGANTEH",
        "first_name": "TANGWAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-01",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN2000285",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "2025030771",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arnold, MO

Sources for this page

Verify at the official NPI Registry.