Individual provider Active NPI

Hoang Huy Nguyen, DDS

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1629123633
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39455 Issued in CA
Practice address
9225 Mira Mesa Blvd
Ste. 218
San Diego, CA 92126-4820
Phone
(858) 689-9295
Fax
(858) 689-9301
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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 39455 CA Primary

Addresses

Primary practice location

9225 Mira Mesa Blvd
Ste. 218
San Diego, CA 92126-4820

Mailing address

9225 Mira Mesa Blvd
Ste. 218
San Diego, CA 92126-4820
Phone (858) 689-9295

Other identifiers 2

IdentifierTypeStateIssuer
39455OtherCASTATE LICENSE NUMBER
B39455-01MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160627001045 CA Order and Referring Only - DentistPractitioner - Dentist 9537450333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1629123633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9225 MIRA MESA BLVD",
            "address_2": "STE. 218",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264820",
            "telephone_number": "858-689-9295",
            "fax_number": "858-689-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9225 MIRA MESA BLVD",
            "address_2": "STE. 218",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264820",
            "telephone_number": "858-689-9295",
            "fax_number": "858-689-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "HOANG",
        "middle_name": "HUY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "39455",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B39455-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.