Active NPI
Alec C Nguyen, DDS
- Pediatric Dentistry
- Scranton, PA
National Provider Identifier
1164711529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DS041541
- Practice address
- 313 Mulberry St
Scranton, PA 18503-1221 - Phone
- (917) 232-0699
- NPI assigned
- Apr 6, 2011
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DS041541 | PA | Primary |
Addresses
Primary practice location
313 Mulberry St
Scranton, PA 18503-1221
Mailing address
313 Mulberry St
Scranton, PA 18503-1221
Phone (917) 232-0699
Other practice location 1
55 University Heights Dr
Stony Brook, NY 11790-2730
Phone (917) 232-0699
Other practice location 2
900 Schechter Dr
Wilkes Barre, PA 18702-6781
Phone (570) 822-4181
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
| License | State | Type | Specialty |
|---|---|---|---|
| DS041541 | PA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Ross Wezmar DDS PC | Past | Accepting new patients | |
| S4K Wilkes-Barre, LLC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Affiliated Pediatric Dentistry
- Point of Service
- Wilkes Barre, PA
- NPI 1942542246
-
- Pediatric Dentistry
- Wilkes Barre, PA
- NPI 1881356327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605225600000",
"number": "1164711529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 MULBERRY ST",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185031221",
"telephone_number": "917-232-0699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 MULBERRY ST",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185031221",
"telephone_number": "917-232-0699"
}
],
"practiceLocations": [
{
"address_1": "55 University Heights Dr",
"address_purpose": "LOCATION",
"city": "Stony Brook",
"state": "NY",
"postal_code": "117902730",
"country_code": "US",
"telephone_number": "917-232-0699",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "900 Schechter Dr",
"address_purpose": "LOCATION",
"city": "Wilkes Barre",
"state": "PA",
"postal_code": "187026781",
"country_code": "US",
"telephone_number": "570-822-4181",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "ALEC",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-06",
"last_updated": "2020-11-13",
"certification_date": "2020-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "PA",
"license": "DS041541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.