Active NPI
David Nguyen, D.M.D.
- General Practice Dentistry
- Fayetteville, NC
National Provider Identifier
1659434363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12187
- Practice address
- 6402 Yadkin Rd
Fayetteville, NC 28303 - Phone
- (910) 864-4646
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12187 | NC | Primary |
Addresses
Primary practice location
6402 Yadkin Rd
Fayetteville, NC 28303
Mailing address
6402 Yadkin Rd
Fayetteville, NC 28303
Phone (910) 864-4646
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30304681 | Medicaid | NH |
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 |
|---|---|---|---|
| 12187 | NC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeremiah C Davis, DDS, Mba, PA | Current | Accepting new patients | |
| Derry Dental Associates | General Practice | Past | Accepting new patients |
| David J Harsant DDS PA | General Practice | Past | Accepting new patients |
Locations
6402 Yadkin Rd
Fayetteville, NC 28303
Phone (910) 864-4646
Organizations & group practices 3
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.
-
dba The Teeth Doctors
- Dental Clinic/Center
- Fayetteville, NC
- NPI 1811497761
-
- General Practice Dentistry
- Fayetteville, NC
- NPI 1659490282
-
- General Practice Dentistry
- Derry, NH
- NPI 1457374712
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640217600000",
"number": "1659434363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6402 YADKIN RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "28303",
"telephone_number": "910-864-4646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6402 YADKIN RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "28303",
"telephone_number": "910-864-4646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2021-12-23",
"certification_date": "2021-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "12187",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30304681",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.