Individual provider Active NPI

Nathan Nguyen Trang Nguyen, DMD

  • Periodontics
  • Westminster, CA
National Provider Identifier
1366566390
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
34530 Issued in CA
Practice address
8102 Westminster Blvd Ste B
Westminster, CA 92683-3363
Phone
(714) 897-3100
Fax
(714) 897-6343
NPI assigned
Mar 16, 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
Periodontics 1223P0300X 34530 CA Primary

Addresses

Primary practice location

8102 Westminster Blvd Ste B
Westminster, CA 92683-3363

Mailing address

8102 Westminster Blvd Ste B
Westminster, CA 92683-3363
Phone (714) 897-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150630002964 CA Order and Referring Only - Other (Non-Physician) 2062724263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34530CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Nguyen Trang Nguyen DMD Inc Periodontics Current Accepting new patients
Nathan N.T. Nguyen DMD Inc Periodontics Current Accepting new patients
Quynh Nhu Phan DMD Inc PastSince Sep 13, 2020 Accepting new patients

Locations

8102 Westminster Blvd
Ste B
Westminster, CA 92683
Phone (714) 897-3100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366566390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8102 WESTMINSTER BLVD STE B",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926833363",
            "telephone_number": "714-897-3100",
            "fax_number": "714-897-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8102 WESTMINSTER BLVD STE B",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926833363",
            "telephone_number": "714-897-3100",
            "fax_number": "714-897-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "NATHAN NGUYEN",
        "middle_name": "TRANG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "34530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

Verify at the official NPI Registry.