Active NPI
Kiet Anh Nguyen, DMD
- General Practice Dentistry
- San Jose, CA
National Provider Identifier
1508916487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 43052
- Practice address
- 2593 S King Rd
Suite #5
San Jose, CA 95122-1880 - Phone
- (408) 223-6336
- Fax
- (408) 223-7561
- NPI assigned
- Jan 11, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 43052 | CA | Primary |
Addresses
Primary practice location
2593 S King Rd
Suite #5
San Jose, CA 95122-1880
Mailing address
2596 Bentley Ridge Dr
San Jose, CA 95138-2436
Phone (408) 274-5420
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G91465 | Other | CA | DENTICAL |
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 |
|---|---|---|---|
| 43052 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kiet Nguyen DMD Dental Professional Corporation | Current | Accepting new patients | |
| Elaine L. Van, DDS | Current | Accepting new patients |
Locations
2593 S King Rd
Ste 5
San Jose, CA 95122
Phone (408) 223-6336
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.
-
- Dentist
- San Jose, CA
- NPI 1710382361
-
- Dentist
- Morgan Hill, CA
- NPI 1316342694
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508916487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2596 BENTLEY RIDGE DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951382436",
"telephone_number": "408-274-5420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2593 S KING RD",
"address_2": "SUITE #5",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951221880",
"telephone_number": "408-223-6336",
"fax_number": "408-223-7561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KIET",
"middle_name": "ANH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "43052",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL",
"identifier": "G91465",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
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.