Active NPI
An Tat Nguyen, DDS
- Dentist
- Irving, TX
National Provider Identifier
1164525192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 20493
- Practice address
- 3425 Grande Bulevar
Irving, TX 75062 - Phone
- (972) 639-5836
- Fax
- (469) 586-4761
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 20493 | TX | Primary |
Addresses
Primary practice location
3425 Grande Bulevar
Irving, TX 75062
Mailing address
3425 Grande Bulevar
Irving, TX 75062-5108
Phone (972) 639-5836
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20493 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571356800000",
"number": "1164525192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3425 GRANDE BULEVAR",
"city": "IRVING",
"state": "TX",
"postal_code": "750625108",
"telephone_number": "972-639-5836",
"fax_number": "469-586-4761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3425 GRANDE BULEVAR",
"city": "IRVING",
"state": "TX",
"postal_code": "75062",
"telephone_number": "972-639-5836",
"fax_number": "469-586-4761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "AN",
"middle_name": "TAT",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2019-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "20493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.