Individual provider Active NPI

Peter Luan Nguyen, D.D.S.

  • Dentist
  • Saint Paul, MN
National Provider Identifier
1124274642
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12545 Issued in MN
Practice address
225 University Ave W
Suite 124
Saint Paul, MN 55103-2045
Phone
(651) 222-6738
Fax
(651) 848-0808
NPI assigned
Aug 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12545 MN Primary

Addresses

Primary practice location

225 University Ave W
Suite 124
Saint Paul, MN 55103-2045

Mailing address

225 University Ave W
Suite 124
Saint Paul, MN 55103-2045
Phone (651) 222-6738

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
12545MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218758400000",
    "number": "1124274642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 UNIVERSITY AVE W",
            "address_2": "SUITE 124",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551032045",
            "telephone_number": "651-222-6738",
            "fax_number": "651-848-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 UNIVERSITY AVE W",
            "address_2": "SUITE 124",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551032045",
            "telephone_number": "651-222-6738",
            "fax_number": "651-848-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PETER",
        "middle_name": "LUAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2008-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "12545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.