Tuan A Q Nguyen, DMD
Individual provider Active NPI General Practice Dentistry · Brando, FL
NPI 1730601329 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1730601329
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DN22894 (FL)
- Practice address
- 511 W Brandon Blvd
Brando, FL 33511-5003 - Phone
- (813) 381-5632
- NPI assigned
- Jul 14, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240122001051 | FL | Order and Referring Only - Dentist |
7810260684 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN22894 | FL | MD | General Practice Dentistry |
Networks
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN22894 | FL | Yes |
Addresses
Primary practice location
511 W Brandon Blvd
Brando, FL 33511-5003
Mailing address
511 W Brandon Blvd
Brandon, FL 33511-5003
Phone (813) 381-5632
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.