Individual provider Active NPI

Yen Kim Nguyen, DDS

  • Dentist
  • City of Industry, CA
National Provider Identifier
1487728986
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
45739 Issued in CA
Practice address
15251 Gale Ave
City of Industry, CA 91745-1507
Phone
(626) 855-4701
Fax
(626) 855-4703
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 45739 CA Primary

Addresses

Primary practice location

15251 Gale Ave
City of Industry, CA 91745-1507

Mailing address

15251 Gale Ave
City of Industry, CA 91745-1507
Phone (626) 855-4701

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160316001405 CA Order and Referring Only - DentistPractitioner - Dentist 0749586840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
45739CAMDGeriatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ngo & Nguyen, Apdc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1487728986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15251 GALE AVE",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917451507",
            "telephone_number": "626-855-4701",
            "fax_number": "626-855-4703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15251 GALE AVE",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917451507",
            "telephone_number": "626-855-4701",
            "fax_number": "626-855-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "YEN",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "45739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in City of Industry, CA

Sources for this page

Verify at the official NPI Registry.