Individual provider Active NPI

Kevin Quang Nguyen, D.M.D.

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1548713209
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
32028 Issued in TX
Practice address
4343 W Camp Wisdom Rd Ste 102
Dallas, TX 75237-2467
Phone
(469) 321-3383
NPI assigned
Jul 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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 32028 TX Primary

Addresses

Primary practice location

4343 W Camp Wisdom Rd Ste 102
Dallas, TX 75237-2467

Mailing address

2704 Ridgeview Dr
Sachse, TX 75048-4330
Phone (469) 321-3383

Other practice location 1

4610 North St
Ste. 101
Nacogdoches, TX 75965-1840
Phone (936) 560-0900

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
32028TXMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1548713209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 RIDGEVIEW DR",
            "city": "SACHSE",
            "state": "TX",
            "postal_code": "750484330",
            "telephone_number": "469-321-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 W CAMP WISDOM RD STE 102",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752372467",
            "telephone_number": "469-321-3383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4610 North St",
            "address_2": "Ste. 101",
            "address_purpose": "LOCATION",
            "city": "Nacogdoches",
            "state": "TX",
            "postal_code": "759651840",
            "country_code": "US",
            "telephone_number": "936-560-0900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KEVIN",
        "middle_name": "QUANG",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-29",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32028",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 3, 2019; 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.