Active NPI
Jaime A Nguyen, DDS
- General Practice Dentistry
- Garden Grove, CA
National Provider Identifier
1174623615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 47396
- Practice address
- 9871 Chapman Ave
Garden Grove, CA 92841-2710 - Phone
- (714) 534-7290
- Fax
- (714) 534-7542
- NPI assigned
- Sep 24, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 47396 | CA | Primary |
Addresses
Primary practice location
9871 Chapman Ave
Garden Grove, CA 92841-2710
Mailing address
9871 Chapman Ave
Garden Grove, CA 92841-2710
Phone (714) 534-7290
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160122001971 | CA | Order and Referring Only - Oral Surgery | 9032412101 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47396 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jaime a Nguyen DDS a Professional Dental Corporation | Past | Accepting new patients |
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.
-
- Dentist
- Garden Grove, CA
- NPI 1508256454
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403136000000",
"number": "1174623615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9871 CHAPMAN AVE",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928412710",
"telephone_number": "714-534-7290",
"fax_number": "714-534-7542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9871 CHAPMAN AVE",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928412710",
"telephone_number": "714-534-7290",
"fax_number": "714-534-7542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "JAIME",
"middle_name": "A",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-24",
"last_updated": "2014-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "47396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.