Active NPI
Nick Khanh Nguyen, DDS
- Dentist
- Aliso Viejo, CA
National Provider Identifier
1649340274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 48838
- Practice address
- 22912 Pacific Park Dr Ste a
Aliso Viejo, CA 92656-5328 - Phone
- (949) 215-4400
- Fax
- (949) 215-4402
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 48838 | CA | Primary |
Addresses
Primary practice location
22912 Pacific Park Dr Ste a
Aliso Viejo, CA 92656-5328
Mailing address
24992 Hollyberry LN
Laguna Niguel, CA 92677-3794
Phone (949) 831-6490
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48838 | Other | CA | DENTAL LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48838 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649340274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24992 HOLLYBERRY LN",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926773794",
"telephone_number": "949-831-6490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22912 PACIFIC PARK DR STE A",
"city": "ALISO VIEJO",
"state": "CA",
"postal_code": "926565328",
"telephone_number": "949-215-4400",
"fax_number": "949-215-4402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "NICK",
"middle_name": "KHANH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "48838",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE NUMBER",
"identifier": "48838",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aliso Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.