Individual provider Active NPI

Timothy Nguyen, DDS

  • General Practice Dentistry
  • Fountain Valley, CA
National Provider Identifier
1164249181
Registry record updated Sep 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS110735 Issued in CA
Practice address
9737 Turtledove Ave
Fountain Valley, CA 92708-5854
Phone
(714) 696-2936
NPI assigned
Sep 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2024

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 DDS110735 CA Primary

Addresses

Primary practice location

9737 Turtledove Ave
Fountain Valley, CA 92708-5854

Mailing address

9737 Turtledove Ave
Fountain Valley, CA 92708-5854
Phone (714) 696-2936

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
DDS110735CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1726876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726876800000",
    "number": "1164249181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9737 TURTLEDOVE AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085854",
            "telephone_number": "714-696-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9737 TURTLEDOVE AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085854",
            "telephone_number": "714-696-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-21",
        "last_updated": "2024-09-21",
        "certification_date": "2024-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS110735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2024; 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.