Active NPI
Audrey Nguyen, DDS
- Dentist
- Medford, OR
National Provider Identifier
1487546628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D12240
- Practice address
- 773 Golf View Dr
Medford, OR 97504-9643 - Phone
- (855) 433-6825
- NPI assigned
- Jul 21, 2025
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D12240 | OR | Primary |
Addresses
Primary practice location
773 Golf View Dr
Medford, OR 97504-9643
Mailing address
3366 Gingham CT
Chino Hills, CA 91709-2811
Phone (909) 470-5710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- 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 |
|---|---|---|---|---|
| I20260219004152 | OR | Order and Referring Only - Dentist | 8820579667 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D12240 | OR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753056000000",
"number": "1487546628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3366 GINGHAM CT",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917092811",
"telephone_number": "909-470-5710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "773 GOLF VIEW DR",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975049643",
"telephone_number": "855-433-6825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "AUDREY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-21",
"last_updated": "2025-07-21",
"certification_date": "2025-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D12240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; 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.