Individual provider Active NPI

Dennis Nguyen, D.D.S.

  • Dentist
  • Cape Girardeau, MO
National Provider Identifier
1366845299
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2014030793 Issued in MO
Practice address
2906 Breckenridge Dr
Cape Girardeau, MO 63701-1728
Phone
(573) 334-8798
Fax
(573) 334-1370
NPI assigned
Oct 6, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2014030793 MO Primary

Addresses

Primary practice location

2906 Breckenridge Dr
Cape Girardeau, MO 63701-1728

Mailing address

2906 Breckenridge Dr
Cape Girardeau, MO 63701-1728
Phone (573) 334-8798

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
2014030793MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Girardeau Dentistry, LLC CurrentSince Mar 29, 2020 Accepting new patients

Locations

2906 Breckenridge Dr
Cape Girardeau, MO 63701
Phone (573) 334-8798

Organizations & group practices 1

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": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1366845299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 BRECKENRIDGE DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637011728",
            "telephone_number": "573-334-8798",
            "fax_number": "573-334-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 BRECKENRIDGE DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637011728",
            "telephone_number": "573-334-8798",
            "fax_number": "573-334-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-06",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2014030793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.