Individual provider Active NPI

An T Nguyen, D.D.S.

  • General Practice Dentistry
  • Forest Hills, NY
National Provider Identifier
1578896676
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
054465-1 Issued in NY
Practice address
7031A 108TH St
Suite 1
Forest Hills, NY 11375-4424
Phone
(718) 263-0223
Fax
(763) 201-5147
NPI assigned
Sep 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 010096 CT
General Practice Dentistry 1223G0001X 054465-1 NY Primary

Addresses

Primary practice location

7031A 108TH St
Suite 1
Forest Hills, NY 11375-4424

Mailing address

14468 26TH Ave
Floor 2
Flushing, NY 11354-1327
Phone (212) 729-6839

Other identifiers 1

IdentifierTypeStateIssuer
03253207MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150820009922 NY Order and Referring Only - Other (Non-Physician) 8022323013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054465-1NYMDGeneral Practice Dentistry
010096CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atn Dental PLLC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430956800000",
    "number": "1578896676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14468 26TH AVE",
            "address_2": "FLOOR 2",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113541327",
            "telephone_number": "212-729-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7031A 108TH ST",
            "address_2": "SUITE 1",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754424",
            "telephone_number": "718-263-0223",
            "fax_number": "763-201-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "AN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2015-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "010096",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054465-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03253207",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.