Individual provider Active NPI

Daniel Nguyen, DDS

  • General Practice Dentistry
  • Downey, CA
National Provider Identifier
1154059194
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
107674 Issued in CA
Practice address
12214 Lakewood Blvd Ste 102
Downey, CA 90242-2663
Phone
(562) 273-2050
NPI assigned
Aug 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 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 107674 CA Primary

Addresses

Primary practice location

12214 Lakewood Blvd Ste 102
Downey, CA 90242-2663

Mailing address

27 Atascadero
Irvine, CA 92602-1093
Phone (714) 856-6717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221021001123 CA Order and Referring Only - DentistPractitioner - Dentist 4688040207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pessah Dental Corporation CurrentSince Aug 14, 2022 Accepting new patients

Locations

12214 Lakewood Blvd
Ste 102
Downey, CA 90242
Phone (562) 273-2050

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": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1154059194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 ATASCADERO",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021093",
            "telephone_number": "714-856-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12214 LAKEWOOD BLVD STE 102",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422663",
            "telephone_number": "562-273-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DANIEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-09",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.