Organization Active NPI

Kim CHI Nguyen DDS Inc

  • Dentist
  • San Jose, CA
National Provider Identifier
1467877852
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D41657 Issued in CA
Legal business name
KIM CHI NGUYEN DDS INC
Practice address
2593 S King Rd Ste 14
San Jose, CA 95122-1880
Phone
(408) 223-7590
Fax
(408) 223-8683
NPI assigned
Feb 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Authorized official

Name
CHI Kim Nguyen
Title
Owner
Phone
(408) 223-8656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D41657 CA Primary

Addresses

Primary practice location

2593 S King Rd Ste 14
San Jose, CA 95122-1880

Mailing address

2593 S King Rd Ste 14
San Jose, CA 95122-1880
Phone (408) 223-8656

Other identifiers 1

IdentifierTypeStateIssuer
D41657MedicaidCA

National Provider Directory

National Provider Directory

Locations

2593 S King Rd
Ste 14
San Jose, CA 95122
Phone (408) 223-7590

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392940800000",
    "number": "1467877852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2593 S KING RD STE 14",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951221880",
            "telephone_number": "408-223-8656",
            "fax_number": "408-223-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2593 S KING RD STE 14",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951221880",
            "telephone_number": "408-223-7590",
            "fax_number": "408-223-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM CHI NGUYEN DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-21",
        "last_updated": "2014-02-21",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "CHI",
        "authorized_official_middle_name": "KIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-223-8656"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "D41657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D41657",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; 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.