Individual provider Active NPI

Andrew Anh Nguyen, DMD

  • General Practice Dentistry
  • Odessa, TX
National Provider Identifier
1154051860
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38601 Issued in TX
Practice address
1401 E 8TH St
Odessa, TX 79761-4802
Phone
(432) 332-8550
NPI assigned
Jun 15, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 38601 TX Primary

Addresses

Primary practice location

1401 E 8TH St
Odessa, TX 79761-4802

Mailing address

9900 Quail Blvd Apt 235
Austin, TX 78758-5737
Phone (512) 761-1431

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
38601TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Familia Dental Odessa PLLC General Practice CurrentSince Jun 21, 2022 Accepting new patients

Locations

1401 E 8th St
Odessa, TX 79761
Phone (432) 332-8550

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": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1154051860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 QUAIL BLVD APT 235",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585737",
            "telephone_number": "512-761-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E 8TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614802",
            "telephone_number": "432-332-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANDREW",
        "middle_name": "ANH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.