Individual provider Active NPI

Dennis Nguyen Cao, DMD

  • General Practice Dentistry
  • Keller, TX
National Provider Identifier
1205358173
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
37099 Issued in TX
Practice address
460 Keller Pkwy
Keller, TX 76248-2370
Phone
(817) 242-6374
NPI assigned
Jul 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3920-17 MS
Dentist 122300000X 6435-C1 AL
General Practice Dentistry 1223G0001X 37099 TX Primary

Addresses

Primary practice location

460 Keller Pkwy
Keller, TX 76248-2370

Mailing address

120 Hemlock Dr
Diberville, MS 39540-3604
Phone (228) 392-6438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20170927001058 AL Order and Referring Only - DentistPractitioner - Dentist 4789958950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37099TXMDClinical Psychologist
6435-C1ALMDDentist
3920-17MSMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Albert Franklin LLC PastSince Nov 24, 2019 Accepting new patients
Torres Diaz Dental PLLC General Practice PastSince Apr 3, 2022 Accepting new patients

Organizations & group practices 2

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1205358173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HEMLOCK DR",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395403604",
            "telephone_number": "228-392-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482370",
            "telephone_number": "817-242-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAO",
        "first_name": "DENNIS",
        "middle_name": "NGUYEN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3920-17",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "6435-C1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "37099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.