Dan Nguyen, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12042 Issued in OR

Practice address

2510 Game Farm Rd
Springfield, OR 97477-7513

Phone

(855) 433-6825

NPI assigned

Aug 5, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 23, 2025 through Sep 23, 2027

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1164252177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9280 SW 176TH AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970079007",
            "telephone_number": "503-866-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 GAME FARM RD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974777513",
            "telephone_number": "855-433-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D12042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Page Psychiatric Services
• Evan Elliott New, DO
• Colin Patrick Newbill, M.D.
• Tami Newburgh, LCSW
• Alyssa Nguyen, PHARMD
• Joseph Simele Nguyen
• Luat Nguyen, MD
• Son Hai Nguyen, PA
• Viet Quoc Nguyen, PHARMD
• C Tolson Nichols, MD

• General Practice Dentistry in Springfield, OR
• Providers in Springfield, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.