Active NPI
Holly DO Nguyen, D.M.D.
- Pediatric Dentistry
- Philadelphia, PA
National Provider Identifier
1619258969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DS038673
- Practice address
- 2301 E Allegheny Ave Ste 201
Philadelphia, PA 19134-4427 - Phone
- (215) 282-8000
- NPI assigned
- Aug 31, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS038673 | PA | |
| Pediatric Dentistry | 1223P0221X | 22DI02484700 | NJ | |
| Pediatric Dentistry | 1223P0221X | DS038673 | PA | Primary |
Addresses
Primary practice location
2301 E Allegheny Ave Ste 201
Philadelphia, PA 19134-4427
Mailing address
3101 Parkview Walk
Philadelphia, PA 19125-4360
Phone (215) 327-6048
Other practice location 1
805 Route 38
Cherry Hill, NJ 08002-2850
Phone (856) 281-7600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180328002267 | PA | Order and Referring Only - Dentist | 5294097499 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02484700 | NJ | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733270400000",
"number": "1619258969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3101 PARKVIEW WALK",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191254360",
"telephone_number": "215-327-6048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 E ALLEGHENY AVE STE 201",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191344427",
"telephone_number": "215-282-8000"
}
],
"practiceLocations": [
{
"address_1": "805 Route 38",
"address_purpose": "LOCATION",
"city": "Cherry Hill",
"state": "NJ",
"postal_code": "080022850",
"country_code": "US",
"telephone_number": "856-281-7600",
"fax_number": "856-281-7604",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DO NGUYEN",
"first_name": "HOLLY",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-31",
"last_updated": "2024-12-04",
"certification_date": "2024-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS038673",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "22DI02484700",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "PA",
"license": "DS038673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.