Individual provider Active NPI

Keith Nguyen, D.M.D

  • General Practice Dentistry
  • Wilmington, DE
National Provider Identifier
1609957067
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
G1-0001149 Issued in DE
Practice address
2323 Pennsylvania Ave
Lower Level
Wilmington, DE 19806-1332
Phone
(302) 426-0526
Fax
(302) 426-0511
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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 G1-0001149 DE Primary

Addresses

Primary practice location

2323 Pennsylvania Ave
Lower Level
Wilmington, DE 19806-1332

Mailing address

2323 Pennsylvania Ave
LL
Wilmington, DE 19806-1332
Phone (302) 482-4444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170410001557 DE Order and Referring Only - DentistPractitioner - Dentist 4082999180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G1-0001149DEMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aesthetic and Special Care Associates,PA General Practice PastSince May 16, 2005 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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1609957067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 PENNSYLVANIA AVE",
            "address_2": "LL",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198061332",
            "telephone_number": "302-482-4444",
            "fax_number": "302-482-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 PENNSYLVANIA AVE",
            "address_2": "LOWER LEVEL",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198061332",
            "telephone_number": "302-426-0526",
            "fax_number": "302-426-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DE",
            "license": "G1-0001149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.