Dr. Jacqueline B. Nguyen, DDS, Apc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DR. JACQUELINE B. NGUYEN, DDS, APC

Doing business as

Evergreen Dentists

Practice address

2847 S White Rd Ste 204
San Jose, CA 95148-2942

Phone

(408) 238-8380

Fax

(408) 238-8404

NPI assigned

Nov 9, 2018

Last updated

Dec 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jacqueline B Nguyen, DDSNPI 1215059696

Title

Owner/President

Phone

(408) 472-4749

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Evergreen Dentists Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacqueline Nguyen, D.D.S.

  • Dentist
  • Campbell, CA
  • NPI 1215059696
  NPD (past) Authorized official

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

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545350400000",
    "number": "1295203941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2847 S WHITE RD STE 204",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482942",
            "telephone_number": "408-238-8380",
            "fax_number": "408-238-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2847 S WHITE RD STE 204",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482942",
            "telephone_number": "408-238-8380",
            "fax_number": "408-238-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JACQUELINE B. NGUYEN, DDS, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-09",
        "last_updated": "2018-12-21",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "408-472-4749",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "48969",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Dentists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evergreen Dentists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in San Jose, CA
• Providers in San Jose, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2018; 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.