Individual provider Active NPI

Canh Thy Nguyen, DMD

  • General Practice Dentistry
  • Sacramento, CA
National Provider Identifier
1255544797
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
52440 Issued in CA
Practice address
930 Florin Rd
Sacramento, CA 95831
Phone
(916) 706-1915
Fax
(916) 706-1909
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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 52440 CA Primary

Addresses

Primary practice location

930 Florin Rd
Sacramento, CA 95831

Mailing address

930 Florin Rd
Sacramento, CA 95831
Phone (916) 706-1915

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

LicenseStateTypeSpecialty
52440CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1255544797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 FLORIN RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95831",
            "telephone_number": "916-706-1915",
            "fax_number": "916-706-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 FLORIN RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95831",
            "telephone_number": "916-706-1915",
            "fax_number": "916-706-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CANH",
        "middle_name": "THY",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.