Active NPI
Mark Tu Nguyen, D.D. S.
- General Practice Dentistry
- Fort Worth, TX
National Provider Identifier
1508876459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 19326
- Practice address
- 7630 N Beach St
Suite 130
Fort Worth, TX 76137-3018 - Phone
- (817) 605-7272
- Fax
- (817) 605-7270
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 19326 | TX | Primary |
Addresses
Primary practice location
7630 N Beach St
Suite 130
Fort Worth, TX 76137-3018
Mailing address
7630 N Beach St
Suite 130
Fort Worth, TX 76137-3018
Phone (817) 605-7272
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19326 | Other | TX | STATE DENTAL LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19326 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508876459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7630 N BEACH ST",
"address_2": "SUITE 130",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761373018",
"telephone_number": "817-605-7272",
"fax_number": "817-605-7270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7630 N BEACH ST",
"address_2": "SUITE 130",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761373018",
"telephone_number": "817-605-7272",
"fax_number": "817-605-7270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "MARK",
"middle_name": "TU",
"name_prefix": "Dr.",
"credential": "D.D. S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "19326",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE DENTAL LICENSE",
"identifier": "19326",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.