Khoi Ngoc Nguyen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53722 Issued in CA

Practice address

1711 Via El Prado Ste 303
Redondo Beach, CA 90277-5723

Phone

(310) 889-8734

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Khoi Nguyen Professional Dental Corporation

  • Dental Clinic/Center
  • Redondo Beach, CA
  • NPI 1821804584
  NPD Authorized official
• Watanabe and Lynn Dental Corporation

  dba Marketplace Dental Group

  • General Practice Dentistry
  • Lake Elsinore, CA
  • NPI 1396830790
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733529600000",
    "number": "1568541191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 VIA EL PRADO STE 303",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775723",
            "telephone_number": "310-844-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 VIA EL PRADO STE 303",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775723",
            "telephone_number": "310-889-8734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29273 Central Ave",
            "address_2": "SUITE # A",
            "address_purpose": "LOCATION",
            "city": "Lake Elsinore",
            "state": "CA",
            "postal_code": "925322254",
            "country_code": "US",
            "telephone_number": "951-245-8664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KHOI",
        "middle_name": "NGOC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2024-12-07",
        "certification_date": "2024-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Yen Nguyen, OD
• Dung Thuy Nguyen, ASW
• Jenny Kim Nguyen, PHARM.D
• Katherine Le Nguyen, O.D.
• Khanh Truong Nguyen, M.D.
• Loan Ngoc Nguyen, PHARM D
• Mitchell Nguyen
• Tiffany Nguyen, DDS, MS
• Trung Nguyen
• Molly Beth Nickerson, MSW, ACSW

• General Practice Dentistry in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2024; 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.