Individual provider Active NPI

Daniel Dung Tien Nguyen, D.D.S.

  • Dentist
  • Chino, CA
National Provider Identifier
1508047929
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
47531 Issued in CA
Practice address
4036 Grand Ave
Suite D
Chino, CA 91710-5487
Phone
(909) 627-9996
NPI assigned
Nov 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150406000444 CA Order and Referring Only - DentistPractitioner - Dentist 1052639978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Nguyen DDS Inc Dentist Past Accepting new patients
Fenny Virgin, DDS, Inc. 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 and National Provider Directory roles.

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

Sources for this page

Verify at the official NPI Registry.