Individual provider Active NPI

Dan C. Nguyen, DDS, MS, PHD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • La Mirada, CA
National Provider Identifier
1255549853
Registry record updated Jan 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
46308 Issued in CA
Practice address
15775 Imperial Hwy
La Mirada, CA 90638-2510
Phone
(562) 943-4488
Fax
(562) 943-4422
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 46308 CA Primary

Addresses

Primary practice location

15775 Imperial Hwy
La Mirada, CA 90638-2510

Mailing address

455 E Columbia St
Long Beach, CA 90806-1620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20151012001489 CA Order and Referring Only - DentistPractitioner - Dentist 3476862509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Nguyen Group Dental Corporation Current Accepting new patients
Perry DO DDS Ms Corp Orthodontics and Dentofacial Orthopedics Past Accepting new patients
Nguyen & DO Dental Corp Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: danguyen@direct.westerndental.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294444800000",
    "number": "1255549853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 E COLUMBIA ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15775 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382510",
            "telephone_number": "562-943-4488",
            "fax_number": "562-943-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DAN",
        "middle_name": "C.",
        "credential": "DDS, MS, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2011-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "46308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mirada, CA

Sources for this page

Verify at the official NPI Registry.