Kenneth Cong Nguyen, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

102236 Issued in CA

Practice address

12132 Brookhurst St
Garden Grove, CA 92840-2817

Phone

(714) 638-7111

NPI assigned

Jan 3, 2018

Last updated

Nov 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Kenny Cong Nguyen Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Tan Nghiem DDS, Inc

  • General Practice Dentistry
  • Garden Grove, CA
  • NPI 1760780910
  NPD
• Vinod G. Rana, DDS., Inc

  dba Brookhurst Dental Group

  • General Practice Dentistry
  • Garden Grove, CA
  • NPI 1295920569
  NPD (past)

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1396252045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2283",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906301783",
            "telephone_number": "626-759-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12132 BROOKHURST ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928402817",
            "telephone_number": "714-638-7111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 E 31st St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946021018",
            "country_code": "US",
            "telephone_number": "510-437-8525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3501 Pershing Dr",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799032731",
            "country_code": "US",
            "telephone_number": "707-775-9812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KENNETH",
        "middle_name": "CONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-03",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "34600",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "102236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNY",
            "last_name": "NGUYEN",
            "middle_name": "CONG",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kathy Phuong Nguyen
• Kathy Tram Nguyen, B.A.
• Kelly Tran Nguyen
• Kelvin Nguyen
• Kelvin Huy Tang Nguyen, DPM
• Kevin Nguyen, PHARM.D.
• Khang Nguyen
• Khang Nguyen, BCBA
• Khanh Bao Nguyen, M.D.
• Kieu-Nhi Nguyen, MT

• Dentist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.