Kim N. Doan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 21365 Issued in FL

Practice address

5937 University Blvd W
Jacksonville, FL 32216-4911

Phone

(904) 730-4150

NPI assigned

Jul 13, 2015

Last updated

Jul 13, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kim Thu Thi Nguyen Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1629452362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5937 UNIVERSITY BLVD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5937 UNIVERSITY BLVD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164911",
            "telephone_number": "904-730-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOAN",
        "first_name": "KIM",
        "middle_name": "N.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 21365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "NGUYEN",
            "middle_name": "THU THI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nguyen DO, D.D.S.
• Van Thuy DO, PHARMD
• VI DO
• Binh Q Doan, MD
• Khoa Doan, PHARMD
• Tad C Doan, DO
• Mark Alan Dobbertien, D.O.
• Robert Newton Dobbins III, RPH
• Gloria Myriam Dobies, ARNP
• Ashley Doble

• General Practice Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; 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.

Verify at the official NPI Registry.