Individual provider Active NPI

Minh N Dang, O.D.

  • Optometrist
  • San Jose, CA
National Provider Identifier
1144240896
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10074T Issued in CA
Practice address
3571 N 1St St Ste 200
San Jose, CA 95134-2405
Phone
(408) 424-2000
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10074T CA Primary

Addresses

Primary practice location

3571 N 1St St Ste 200
San Jose, CA 95134-2405

Mailing address

3571 N 1St St Ste 200
San Jose, CA 95134-2405
Phone (408) 244-2000

Other practice location 1

598 E Santa Clara St
Suite #260
San Jose, CA 95112-2036
Phone (408) 993-2288

Other practice location 2

598 E Santa Clara St
Suite #260
San Jose, CA 95112-2036
Phone (408) 993-2288

Other identifiers 1

IdentifierTypeStateIssuer
SD010074MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10074TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
VSP Retail Inc PastSince Jun 5, 2022 Accepting new patients

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1144240896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3571 N 1ST ST STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951342405",
            "telephone_number": "408-244-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3571 N 1ST ST STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951342405",
            "telephone_number": "408-424-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "598 E Santa Clara St",
            "address_2": "SUITE #260",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951122036",
            "country_code": "US",
            "telephone_number": "408-993-2288",
            "fax_number": "408-295-4051",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "598 E Santa Clara St",
            "address_2": "SUITE #260",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951122036",
            "country_code": "US",
            "telephone_number": "408-993-2288",
            "fax_number": "408-295-4051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANG",
        "first_name": "MINH",
        "middle_name": "N",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10074T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD010074",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.