Individual provider Active NPI

Cory Nhut Nguyen, DDS

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1497894919
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21686 Issued in TX
Practice address
13655 Preston Rd Ste 100
Dallas, TX 75240-4783
Phone
(214) 357-6100
Fax
(972) 276-7373
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 21686 TX Primary

Addresses

Primary practice location

13655 Preston Rd Ste 100
Dallas, TX 75240-4783

Mailing address

126 N International Rd Ste a
Suite a
Garland, TX 75042-6515
Phone (972) 276-7300

Other identifiers 2

IdentifierTypeStateIssuer
201351108MedicaidTX
473523095OtherTXTAX ID

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
21686TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Above and Beyond Management CurrentSince Oct 13, 2019 Accepting new patients
Above and Beyond Management Inc CurrentSince Nov 1, 2019 Accepting new patients

Locations

13655 Preston Rd
Ste 100
Dallas, TX 75240
Phone (214) 357-6100

13655 Preston Rd
Dallas, TX 75240
Phone (214) 357-6100

Organizations & group practices 2

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1497894919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 N INTERNATIONAL RD STE A",
            "address_2": "SUITE A",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750426515",
            "telephone_number": "972-276-7300",
            "fax_number": "972-276-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13655 PRESTON RD STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404783",
            "telephone_number": "214-357-6100",
            "fax_number": "972-276-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CORY",
        "middle_name": "NHUT",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201351108",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "473523095",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.