Individual provider Active NPI

Nhung Nong, DMD

  • General Practice Dentistry
  • Winter Haven, FL
National Provider Identifier
1306094313
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN18375 Issued in FL
Practice address
5535 Cypress Gardens Blvd Ste 120
Winter Haven, FL 33884-2211
Phone
(863) 326-1600
NPI assigned
Sep 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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 DN18375 FL Primary

Addresses

Primary practice location

5535 Cypress Gardens Blvd Ste 120
Winter Haven, FL 33884-2211

Mailing address

5535 Cypress Gardens Blvd Ste 120
Winter Haven, FL 33884-2211
Phone (863) 326-1600

Other practice location 1

100 Whetstone Pl
Suite 308
St Augustine, FL 32086-5774
Phone (904) 810-2345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN18375FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smiles of Winter Haven, PLLC General Practice Past Accepting new patients
FL Southern Dental PA General Practice PastSince Mar 19, 2023 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1306094313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 CYPRESS GARDENS BLVD STE 120",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338842211",
            "telephone_number": "863-326-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 CYPRESS GARDENS BLVD STE 120",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338842211",
            "telephone_number": "863-326-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Whetstone Pl",
            "address_2": "Suite 308",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865774",
            "country_code": "US",
            "telephone_number": "904-810-2345",
            "fax_number": "904-810-5334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NONG",
        "first_name": "NHUNG",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.