Individual provider Active NPI

Timothy Nguyen, D.M.D.

  • General Practice Dentistry
  • Plano, TX
National Provider Identifier
1649647512
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31342 Issued in TX
Practice address
4709 W. Parker Rd
Ste. 515
Plano, TX 75093
Phone
(972) 985-0005
Fax
(972) 985-0012
NPI assigned
Aug 27, 2015
Last updated
Dec 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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 31342 TX Primary

Addresses

Primary practice location

4709 W. Parker Rd
Ste. 515
Plano, TX 75093

Mailing address

4709 W. Parker Rd
Ste. 515
Plano, TX 75093
Phone (972) 985-0005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20151222001731 TX Order and Referring Only - DentistPractitioner - Dentist 2466753124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31342TXMDPharmacy

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1649647512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 W. PARKER RD",
            "address_2": "STE. 515",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75093",
            "telephone_number": "972-985-0005",
            "fax_number": "972-985-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 W. PARKER RD",
            "address_2": "STE. 515",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75093",
            "telephone_number": "972-985-0005",
            "fax_number": "972-985-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.