Individual provider Active NPI

CHI Thien Nguyen, DDS

  • General Practice Dentistry
  • Ruskin, FL
National Provider Identifier
1720170871
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN13524 Issued in FL
Practice address
768 Cortaro Dr
Ruskin, FL 33573-6811
Phone
(813) 642-8885
Fax
(813) 664-2889
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DN13524 FL Primary

Addresses

Primary practice location

768 Cortaro Dr
Ruskin, FL 33573-6811

Mailing address

PO Box 5340
Sun City Center, FL 33571-5340
Phone (813) 642-8885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160323001448 FL Order and Referring Only - DentistPractitioner - Dentist 7810294592

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN13524FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
CHI T. Nguyen, DDS, PA Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720170871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5340",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335715340",
            "telephone_number": "813-642-8885",
            "fax_number": "813-633-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 CORTARO DR",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335736811",
            "telephone_number": "813-642-8885",
            "fax_number": "813-664-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CHI",
        "middle_name": "THIEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN13524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruskin, FL

Sources for this page

Verify at the official NPI Registry.