Individual provider Active NPI

Viet Quoc Nguyen, D.D.S.

  • General Practice Dentistry
  • Poway, CA
National Provider Identifier
1376513861
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53255 Issued in CA
Practice address
12630 Monte Vista Rd Ste 109
Poway, CA 92064-2526
Phone
(858) 675-2285
Fax
(858) 675-9015
NPI assigned
Jan 25, 2006
Last updated
Mar 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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 53255 CA Primary

Addresses

Primary practice location

12630 Monte Vista Rd Ste 109
Poway, CA 92064-2526

Mailing address

12630 Monte Vista Rd Ste 109
Poway, CA 92064-2526
Phone (858) 675-2285

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151006002589 CA Order and Referring Only - DentistPractitioner - Dentist 7719295088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rogers and Reagan Dental Corporation General Practice PastSince May 1, 2020 Accepting new patients
John C. Nosti, D.D.S. Inc. General Practice Past Accepting new patients

Organizations & group practices 2

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1376513861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12630 MONTE VISTA RD STE 109",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642526",
            "telephone_number": "858-675-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12630 MONTE VISTA RD STE 109",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642526",
            "telephone_number": "858-675-2285",
            "fax_number": "858-675-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VIET",
        "middle_name": "QUOC",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

Verify at the official NPI Registry.