Individual provider Active NPI

Dustin Nguyen, MD

  • Pediatric Obesity Medicine Physician
  • Richmond, VA
National Provider Identifier
1114540572
Registry record updated Jul 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Obesity Medicine PhysicianTaxonomy code 2080B0002X
License
0101289540 Issued in VA
Practice address
1000 E Broad St
Richmond, VA 23219-1930
Phone
(804) 828-3931
NPI assigned
May 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301509104 MI
Pediatric Obesity Medicine Physician 2080B0002X 0101289540 VA Primary

Addresses

Primary practice location

1000 E Broad St
Richmond, VA 23219-1930

Mailing address

PO Box 980257
Richmond, VA 23298-0257
Phone (804) 828-9783

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230807003488 MI Practitioner - Pediatric Medicine 7416379748 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301509104MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Pediatrics CurrentSince Jul 5, 2023 Accepting new patients
Regents of the University of Michigan Pediatrics Current Accepting new patients
Regents of the University of Michigan CurrentSince Jul 5, 2023 Accepting new patients

Locations

400 E Eisenhower Pkwy
Ste B
Ann Arbor, MI 48108
Phone (734) 232-2600

400 E Eisenhower Pkwy
Ann Arbor, MI 48108
Phone (734) 232-2600

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783209600000",
    "number": "1114540572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980257",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980257",
            "telephone_number": "804-828-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E BROAD ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232191930",
            "telephone_number": "804-828-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-20",
        "last_updated": "2026-07-05",
        "certification_date": "2026-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301509104",
            "primary": false
        },
        {
            "code": "2080B0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Obesity Medicine",
            "state": "VA",
            "license": "0101289540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.