Active NPI
Jessica Ann Nguyen, DMD
- Dentist
- Palm Bay, FL
National Provider Identifier
1215611967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 28118
- Practice address
- 3420 Bayside Lakes Blvd SE
Palm Bay, FL 32909-6894 - Phone
- (321) 722-0155
- NPI assigned
- Jun 13, 2023
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 28118 | FL | Primary |
Addresses
Primary practice location
3420 Bayside Lakes Blvd SE
Palm Bay, FL 32909-6894
Mailing address
7529 Colony Lake Dr
Boynton Beach, FL 33436-1305
Phone (561) 306-3555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28118 | FL | MD | Dentist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782259200000",
"number": "1215611967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7529 COLONY LAKE DR",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "334361305",
"telephone_number": "561-306-3555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3420 BAYSIDE LAKES BLVD SE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329096894",
"telephone_number": "321-722-0155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "JESSICA",
"middle_name": "ANN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-13",
"last_updated": "2026-06-24",
"certification_date": "2026-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "28118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.