Khanhbao Nguyen, PHARMD

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

03136134 Issued in OH

Practice address

4855 N Main St
Dayton, OH 45405-5024

Phone

(937) 279-0468

Fax

(937) 279-2262

NPI assigned

Jun 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Dayton, OH
  • NPI 1972518991
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1592006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1639794886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454055024",
            "telephone_number": "937-279-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454055024",
            "telephone_number": "937-279-0468",
            "fax_number": "937-279-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KHANHBAO",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-13",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "03136134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Dayton",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4855 N Main St",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454055024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashlee Hoang Nguyen
• Daniel Nguyen
• Diep Bich Nguyen, COTA/L
• Donald Huu Nguyen, MD, FAAP
• Hoang Kim Nguyen, D.P.M.
• Kim Thi Nguyen, NP
• Kristie Nguyen, DO
• Marissa Sloane Nguyen, MA, CCC-SLP
• Thong Duc Nguyen, M.D.
• Nic 14 Dayton Leasing LLC

• Community/Retail Pharmacy in Dayton, OH
• Providers in Dayton, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.