Active NPI
Stephanie Nguyen, DMD
- Dentist
- San Diego, CA
National Provider Identifier
1447376462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 50268
- Practice address
- 14391 Penasquitos Dr
Suite a
San Diego, CA 92129-1612 - Phone
- (858) 672-0400
- NPI assigned
- Mar 21, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 50268 | CA | Primary |
Addresses
Primary practice location
14391 Penasquitos Dr
Suite a
San Diego, CA 92129-1612
Mailing address
14391 Penasquitos Dr
Suite a
San Diego, CA 92129-1612
Phone (858) 672-0400
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160328001462 | CA | Order and Referring Only - Dentist | 7012214554 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439510400000",
"number": "1447376462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14391 PENASQUITOS DR",
"address_2": "SUITE A",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921291612",
"telephone_number": "858-672-0400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14391 PENASQUITOS DR",
"address_2": "SUITE A",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921291612",
"telephone_number": "858-672-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "STEPHANIE",
"name_prefix": "Mrs.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2015-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "50268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.