Active NPI
Daniel Dung Tien Nguyen, D.D.S.
- Dentist
- Chino, CA
National Provider Identifier
1508047929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 47531
- Practice address
- 4036 Grand Ave
Suite D
Chino, CA 91710-5487 - Phone
- (909) 627-9996
- NPI assigned
- Nov 15, 2007
- Last updated
- Nov 15, 2007
- Sex
- Male
- 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 | 47531 | CA | Primary |
Addresses
Primary practice location
4036 Grand Ave
Suite D
Chino, CA 91710-5487
Mailing address
4036 Grand Ave
Suite D
Chino, CA 91710-5487
Phone (909) 627-9996
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150406000444 | CA | Order and Referring Only - Dentist | 1052639978 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47531 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fenny Virgin, DDS, Inc. | Past | Accepting new patients | |
| Daniel Nguyen DDS Inc | Dentist | Past | Accepting new patients |
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, 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": "1195084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195084800000",
"number": "1508047929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4036 GRAND AVE",
"address_2": "SUITE D",
"city": "CHINO",
"state": "CA",
"postal_code": "917105487",
"telephone_number": "909-627-9996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4036 GRAND AVE",
"address_2": "SUITE D",
"city": "CHINO",
"state": "CA",
"postal_code": "917105487",
"telephone_number": "909-627-9996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "DANIEL",
"middle_name": "DUNG TIEN",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-15",
"last_updated": "2007-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "47531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chino, CA
- Valerie Nguy, PHARMD
- Nguyen & Truong Dental Corp (Dentistry Today)
- Nguyen and Lac, a Professional Corporation (The Vision Shop Optometry)
- Nguyen-Ho Optometry, PC (Keen Eye Optometry)
- Bao Phuc Nguyen
- Dao Quynn Nguyen, PHD
- Duyen Nguyen, LVN
- Hoan Ngoc Nguyen, M.D.
- Howard Hai Tuan Nguyen, O.D.
- Jessica Nguyen
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.