Individual provider Active NPI

Marie T. Nguyen, D.D.S.

  • General Practice Dentistry
  • Sonora, CA
National Provider Identifier
1669681193
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
48653 Issued in CA
Practice address
19969 Greenley Rd Ste C&D
Sonora, CA 95370-5908
Phone
(209) 532-0034
NPI assigned
May 22, 2007
Last updated
Jun 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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 48653 CA Primary

Addresses

Primary practice location

19969 Greenley Rd Ste C&D
Sonora, CA 95370-5908

Mailing address

2601 La Terrace Cir
San Jose, CA 95123-5338
Phone (408) 568-3930

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

LicenseStateTypeSpecialty
48653CAMDMarriage & Family Therapist

Interoperability endpoints

  • Direct secure messaging: marie.nguyen.p1@direct.tmwihc.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1669681193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 LA TERRACE CIR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951235338",
            "telephone_number": "408-568-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19969 GREENLEY RD STE C&D",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705908",
            "telephone_number": "209-532-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MARIE",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.