Active NPI
Michael Nguyen, D.D.S., M.S.D.
- Periodontics
- Katy, TX
National Provider Identifier
1417482779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 30047
- Practice address
- 810 S Mason Rd Ste 325
Katy, TX 77450-3858 - Phone
- (281) 392-6000
- NPI assigned
- Apr 25, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 30047 | TX | Primary |
Addresses
Primary practice location
810 S Mason Rd Ste 325
Katy, TX 77450-3858
Mailing address
810 S Mason Rd Ste 325
Katy, TX 77450-3858
Phone (281) 392-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210927000726 | TX | Order and Referring Only - Oral Surgery | 1759788235 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30047 | TX | MD | Community/Retail Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Katy Periodontics Management Inc | Periodontics | Past | Accepting new patients |
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.
-
- Periodontics
- Katy, TX
- NPI 1518799626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493078400000",
"number": "1417482779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 S MASON RD STE 325",
"city": "KATY",
"state": "TX",
"postal_code": "774503858",
"telephone_number": "281-392-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 S MASON RD STE 325",
"city": "KATY",
"state": "TX",
"postal_code": "774503858",
"telephone_number": "281-392-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "MICHAEL",
"credential": "D.D.S., M.S.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-25",
"last_updated": "2017-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "30047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.