NPIMap

Organization Active NPI

Mark K. Nguyen Dental Business a Prof Corp

  • Dentist
  • Costa Mesa, CA
National Provider Identifier
1215341359
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
53472 Issued in CA
Legal business name
MARK K. NGUYEN DENTAL BUSINESS A PROF CORP
Practice address
1202 Bristol St
140
Costa Mesa, CA 92626-8605
Phone
(714) 545-0484
NPI assigned
Jun 17, 2014
Last updated
Jun 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Authorized official

Name
Dr. Mark K Nguyen, D.D.S.
Title
Owner
Phone
(714) 545-0484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 53472 CA Primary

Addresses

Primary practice location

1202 Bristol St
140
Costa Mesa, CA 92626-8605

Mailing address

1202 Bristol St.
140
Costa Mesa, CA 92626
Phone (714) 545-0484

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1215341359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 BRISTOL ST.",
            "address_2": "140",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92626",
            "telephone_number": "714-545-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 BRISTOL ST",
            "address_2": "140",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926268605",
            "telephone_number": "714-545-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK K. NGUYEN DENTAL BUSINESS A PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-545-0484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "53472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.