Individual provider Active NPI

Christine Nguyen, DMD

  • General Practice Dentistry
  • Salem, OR
National Provider Identifier
1356776033
Registry record updated Sep 12, 2013
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D9957 Issued in OR
Practice address
4392 Liberty Rd S
Salem, OR 97302-6171
Phone
(503) 585-7447
Fax
(503) 375-8270
NPI assigned
Sep 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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 D9957 OR Primary

Addresses

Primary practice location

4392 Liberty Rd S
Salem, OR 97302-6171

Mailing address

4392 Liberty Rd S
Salem, OR 97302-6171
Phone (503) 585-7447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20170111001369 OR Order and Referring Only - DentistPractitioner - Dentist 6103107826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1356776033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4392 LIBERTY RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026171",
            "telephone_number": "503-585-7447",
            "fax_number": "503-375-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4392 LIBERTY RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026171",
            "telephone_number": "503-585-7447",
            "fax_number": "503-375-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.