Individual provider Active NPI

Paul L Nguyen

  • General Practice Dentistry
  • Prairieville, LA
National Provider Identifier
1205153954
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6027 Issued in LA
Practice address
37279 Market Place Dr
Prairieville, LA 70769-3487
Phone
(225) 673-1647
NPI assigned
Apr 20, 2010
Last updated
Dec 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6027 LA Primary

Addresses

Primary practice location

37279 Market Place Dr
Prairieville, LA 70769-3487

Mailing address

10526 Manchac Pass Ave
Baton Rouge, LA 70817-8335
Phone (225) 614-1359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20151204000588 LA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 1153621669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6027LAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Long Viet Nguyen DDS LLC CurrentSince Dec 13, 2022 Accepting new patients

Locations

37279 Market Place Dr
Prairieville, LA 70769
Phone (225) 673-1647

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1205153954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10526 MANCHAC PASS AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708178335",
            "telephone_number": "225-614-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37279 MARKET PLACE DR",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693487",
            "telephone_number": "225-673-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PAUL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-20",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairieville, LA

Sources for this page

Verify at the official NPI Registry.