Individual provider Active NPI

Toan Minh Nguyen, DMD

  • General Practice Dentistry
  • Indio, CA
National Provider Identifier
1669105144
Registry record updated Jul 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
107564 Issued in CA
Practice address
82151 Avenue 42 Ste 110
Indio, CA 92203-9313
Phone
(760) 255-7597
NPI assigned
Jul 2, 2022
Last updated
Jul 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2022

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 107564 CA Primary

Addresses

Primary practice location

82151 Avenue 42 Ste 110
Indio, CA 92203-9313

Mailing address

8782 Dewey Dr
Garden Grove, CA 92841-1612
Phone (714) 722-9589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20221130002467 CA Order and Referring Only - DentistPractitioner - Dentist 0446628119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alexander Tran Dental Corporation PastSince Jul 10, 2022 Accepting new patients

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": "1656720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656720000000",
    "number": "1669105144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8782 DEWEY DR",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928411612",
            "telephone_number": "714-722-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82151 AVENUE 42 STE 110",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922039313",
            "telephone_number": "760-255-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TOAN",
        "middle_name": "MINH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-02",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.