Individual provider Active NPI

Thien Cong Nguyen, DMD

  • Dentist
  • Tucson, AZ
National Provider Identifier
1124210356
Registry record updated Aug 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D7354 Issued in AZ
Practice address
4001 E Broadway Blvd
Tucson, AZ 85711-3454
Phone
(520) 323-2600
Fax
(520) 323-2800
NPI assigned
Aug 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D7354 AZ Primary

Addresses

Primary practice location

4001 E Broadway Blvd
Tucson, AZ 85711-3454

Mailing address

449 E Elm St
Tucson, AZ 85705-6713
Phone (520) 850-9418

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

LicenseStateTypeSpecialty
D7354AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Canyon Dental Group, PLLC Dentist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tnguyen705479@direct.ochin.org

Organizations & group practices 1

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": "1186876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186876800000",
    "number": "1124210356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 E ELM ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857056713",
            "telephone_number": "520-850-9418",
            "fax_number": "520-323-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 E BROADWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113454",
            "telephone_number": "520-323-2600",
            "fax_number": "520-323-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THIEN",
        "middle_name": "CONG",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-12",
        "last_updated": "2007-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D7354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2007; 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.