Paul Nguyen

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.035082 Issued in IL

Practice address

331 S Main St
Virginia, IL 62691-1571

Phone

(217) 452-3057

NPI assigned

Feb 1, 2024

Last updated

Jul 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: paul.nguyen.p15@direct.fhn-fqhc.nextgenshare.com

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.

• Cass County Public Health Dept

  dba Cass County Health Clinic Beardstown

  • Federally Qualified Health Center (FQHC)
  • Beardstown, IL
  • NPI 1942439310
  NPD (past)

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1184487118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 S MICHIGAN AVE APT 202",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601814101",
            "telephone_number": "713-392-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 S MAIN ST",
            "city": "VIRGINIA",
            "state": "IL",
            "postal_code": "626911571",
            "telephone_number": "217-452-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-01",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.035082",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Dee Hollada, D.C.
• Hayley J Jones, LCSW
• Matthew Aaron Lynch, D.M.D.
• Mecca Paramedics, Inc
• Moreland & Devitt Inc (Moreland & Devitt Pharmacy)
• Abdul Wahid Royeen, M.D
• Dominique Sanchez, D.O.
• Sarah Seely, QMHP
• Evelyn E Sheaff, FNP-BC
• Sherry Ann Slifer, FNP

• General Practice Dentistry in Virginia, IL
• Providers in Virginia, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.

Verify at the official NPI Registry.