Individual provider Active NPI

Tung Nguyen, DDS

  • Dentist
  • New York, NY
National Provider Identifier
1700410479
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
061818 Issued in NY
Practice address
622 W 168TH St
New York, NY 10032-3720
Phone
(402) 617-1825
NPI assigned
Mar 2, 2020
Last updated
Jan 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 061818 NY Primary

Addresses

Primary practice location

622 W 168TH St
New York, NY 10032-3720

Mailing address

741 Glacier TRL
Lincoln, NE 68521-4623
Phone (402) 617-1825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230106002567 NY Practitioner - Dentist 1951771989 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Century Medical & Dental Center Inc CurrentSince Jun 1, 2024 Accepting new patients
United Cerebral Palsy Associations of New York State, Inc. Current Accepting new patients
Metro Community Health Centers, Inc. CurrentSince Dec 12, 2022 Accepting new patients
Metro Community Health Centers, Inc. Current Accepting new patients
Suny Downstate Medical Center Past Accepting new patients

Locations

979 Cross Bronx Expy
Bronx, NY 10460
Phone 71866575653009

200 Livingston St
Brooklyn, NY 11201
Phone (718) 522-3399

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

827 11th Ave
New York, NY 10019
Phone (212) 257-9778

Organizations & group practices 5

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": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1700410479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 GLACIER TRL",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685214623",
            "telephone_number": "402-617-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "402-617-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TUNG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-02",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "061818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.