Individual provider Active NPI

Tri Minh Nguyen, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Victorville, CA
National Provider Identifier
1699327031
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DDS112397 Issued in CA
Practice address
14678 Seventh St Ste 200
Victorville, CA 92395-4002
Phone
(832) 633-4245
NPI assigned
Jul 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DDS112397 CA Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X S2-218 NV

Addresses

Primary practice location

14678 Seventh St Ste 200
Victorville, CA 92395-4002

Mailing address

105 Catalyst
Irvine, CA 92618
Phone (832) 633-4245

Other practice location 1

5642 S Eastern Ave Ste B
Las Vegas, NV 89119-2310
Phone (832) 633-4245

Other practice location 2

Bldg, 390 N Loop Rd,
Fort Irwin, CA 92310
Phone (832) 633-4245

Other practice location 3

410 S Rampart Blvd Ste 360
Las Vegas, NV 89145-5730
Phone (702) 541-8450

Other practice location 4

171 Inner Loop Road
Apo, AA 92310-0000
Phone (760) 380-3173

Other identifiers 1

IdentifierTypeStateIssuer
33933858MedicaidTX

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
DDS112397CAMDOral and Maxillofacial Surgery (Dentist)
S2-218NVMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1699327031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CATALYST",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92618",
            "telephone_number": "832-633-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14678 SEVENTH ST STE 200",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954002",
            "telephone_number": "832-633-4245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5642 S Eastern Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891192310",
            "country_code": "US",
            "telephone_number": "832-633-4245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Bldg, 390 N Loop Rd,",
            "address_purpose": "LOCATION",
            "city": "Fort Irwin",
            "state": "CA",
            "postal_code": "92310",
            "country_code": "US",
            "telephone_number": "832-633-4245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 S Rampart Blvd Ste 360",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891455730",
            "country_code": "US",
            "telephone_number": "702-541-8450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "171 Inner Loop Road",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AA",
            "postal_code": "923100000",
            "country_code": "US",
            "telephone_number": "760-380-3173",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TRI",
        "middle_name": "MINH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS112397",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NV",
            "license": "S2-218",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33933858",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.