Active NPI
Thanh Nguyen Fernandez, DDS
- General Practice Dentistry
- Garland, TX
National Provider Identifier
1477668457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 21700
- Practice address
- 1815 South First Street
Suite H
Garland, TX 75040 - Phone
- (972) 271-4500
- Fax
- (972) 271-4511
- NPI assigned
- Aug 20, 2006
- Last updated
- Mar 13, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 21700 | TX | Primary |
Addresses
Primary practice location
1815 South First Street
Suite H
Garland, TX 75040
Mailing address
16711 Fallen Tree Dr
San Antonio, TX 78247-2036
Phone (972) 375-7519
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 174133210 | Medicaid | TX |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21700 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Excel Dental Clinic of Garland PA | General Practice | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363132800000",
"number": "1477668457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16711 FALLEN TREE DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782472036",
"telephone_number": "972-375-7519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1815 SOUTH FIRST STREET",
"address_2": "SUITE H",
"city": "GARLAND",
"state": "TX",
"postal_code": "75040",
"telephone_number": "972-271-4500",
"fax_number": "972-271-4511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "THANH",
"middle_name": "NGUYEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-20",
"last_updated": "2013-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "21700",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "174133210",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.