Individual provider Active NPI

Loan Thi Nguyen

  • Pharmacist
  • Dorchester, MA
National Provider Identifier
1386368090
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH26942 Issued in MA
Practice address
778 Dudley St
Dorchester, MA 02125-2276
Phone
(617) 825-2572
NPI assigned
Sep 27, 2022
Last updated
Sep 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH26942 MA Primary

Addresses

Primary practice location

778 Dudley St
Dorchester, MA 02125-2276

Mailing address

778 Dudley St
Dorchester, MA 02125-2276
Phone (617) 825-2572

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
PH26942MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1386368090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "778 DUDLEY ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252276",
            "telephone_number": "617-825-2572",
            "fax_number": "617-288-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "778 DUDLEY ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252276",
            "telephone_number": "617-825-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LOAN",
        "middle_name": "THI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH26942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

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