Individual provider Active NPI

Dustin Kientanh Nguyen

  • Pharmacist
  • Lakewood, CA
National Provider Identifier
1467069252
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
83303 Issued in CA
Practice address
5505 Carson St
Lakewood, CA 90713-3004
Phone
(562) 420-1403
NPI assigned
Sep 25, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 83303 CA Primary

Addresses

Primary practice location

5505 Carson St
Lakewood, CA 90713-3004

Mailing address

5505 Carson St
Lakewood, CA 90713-3004
Phone (562) 420-1403

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
83303CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1467069252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 CARSON ST",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907133004",
            "telephone_number": "562-420-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 CARSON ST",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907133004",
            "telephone_number": "562-420-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DUSTIN",
        "middle_name": "KIENTANH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "83303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.