Individual provider Active NPI

Anh Quynh Nguyen, D.D.S

  • Dentist
  • Irving, TX
National Provider Identifier
1134469877
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28647 Issued in TX
Practice address
3425 Grande Bulevar
Irving, TX 75062-5108
Phone
(972) 639-5836
Fax
(469) 586-4761
NPI assigned
Feb 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 28647 TX Primary

Addresses

Primary practice location

3425 Grande Bulevar
Irving, TX 75062-5108

Mailing address

3425 Grande Bulevar
Irving, TX 75062-5108
Phone (972) 639-5836

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
28647TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1360972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1134469877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 GRANDE BULEVAR",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750625108",
            "telephone_number": "972-639-5836",
            "fax_number": "469-586-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 GRANDE BULEVAR",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750625108",
            "telephone_number": "972-639-5836",
            "fax_number": "469-586-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANH",
        "middle_name": "QUYNH",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-16",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; 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.