Individual provider Active NPI

Matthew Nguyen, DDS

  • General Practice Dentistry
  • Oklahoma City, OK
National Provider Identifier
1366172595
Registry record updated Jun 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7582 Issued in OK
Practice address
2750 NW 23Rd St
Oklahoma City, OK 73107-2212
Phone
(405) 942-4445
NPI assigned
Jun 11, 2022
Last updated
Jun 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2022

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 7582 OK Primary

Addresses

Primary practice location

2750 NW 23Rd St
Oklahoma City, OK 73107-2212

Mailing address

3104 SW 110TH Ter
Oklahoma City, OK 73170-2556
Phone (405) 397-7194

Other practice location 1

301 S Boulevard Ste 118
Edmond, OK 73034-3880
Phone (405) 348-9182

Other practice location 2

3104 SW 110th Ter
Oklahoma City, OK 73170-2556
Phone (405) 397-7194

Other names 1

  • Matt Nguyen Other name

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
7582OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Dentistry and Braces CurrentSince Feb 11, 2024 Accepting new patients
North Park Family Dental PastSince Nov 10, 2019 Accepting new patients
Excel Dental PLLC Single Specialty PastSince Jun 21, 2022 Accepting new patients

Locations

2750 NW 23rd St
Oklahoma City, OK 73107
Phone (405) 780-4705

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, 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": "1654905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1366172595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 SW 110TH TER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731702556",
            "telephone_number": "405-397-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 NW 23RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731072212",
            "telephone_number": "405-942-4445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 S Boulevard Ste 118",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730343880",
            "country_code": "US",
            "telephone_number": "405-348-9182",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3104 SW 110th Ter",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731702556",
            "country_code": "US",
            "telephone_number": "405-397-7194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-11",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "7582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATT",
            "last_name": "NGUYEN",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; 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.