Individual provider Active NPI

Cuong Dinh Nguyen, DENTIST

  • Dentist
  • Seattle, WA
National Provider Identifier
1316080583
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00006014 Issued in WA
Practice address
1200 So Jackson Street
Suite 23
Seattle, WA 98144-2042
Phone
(206) 325-5944
Fax
(206) 325-5944
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE00006014 WA Primary

Addresses

Primary practice location

1200 So Jackson Street
Suite 23
Seattle, WA 98144-2042

Mailing address

1200 So Jackson Street
Suite 23
Seattle, WA 98144-2042
Phone (206) 325-5944

Other identifiers 1

IdentifierTypeStateIssuer
5003546MedicaidWA

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
DE00006014WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316080583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SO JACKSON STREET",
            "address_2": "SUITE 23",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442042",
            "telephone_number": "206-325-5944",
            "fax_number": "206-325-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SO JACKSON STREET",
            "address_2": "SUITE 23",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442042",
            "telephone_number": "206-325-5944",
            "fax_number": "206-325-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CUONG",
        "middle_name": "DINH",
        "name_prefix": "Mr.",
        "credential": "DENTIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00006014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5003546",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.