NPIMap

Organization Active NPI

Jimmy Nguyen D.D.S., Inc

  • Preferred Provider Organization
  • Riverside, CA
National Provider Identifier
1750797445
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
57891 Issued in CA
Legal business name
JIMMY NGUYEN D.D.S., INC
Practice address
7120 Indiana Ave
Suite B
Riverside, CA 92504-4562
Phone
(951) 276-2877
Fax
(951) 276-1124
NPI assigned
Jul 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Authorized official

Name
Dr. Jimmy Nguyen
Title
President/Dentist
Phone
(951) 276-2877

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 57891 CA
Health Maintenance Organization 302R00000X 57891 CA
Preferred Provider Organization 305R00000X 57891 CA Primary
Point of Service 305S00000X 57891 CA

Addresses

Primary practice location

7120 Indiana Ave
Suite B
Riverside, CA 92504-4562

Mailing address

7120 Indiana Ave
Suite B
Riverside, CA 92504-4562
Phone (951) 276-2877

Other names 1

  • Melody Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jimmy Nguyen DDS Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7120 Indiana Ave
Ste B
Riverside, CA 92504
Phone (951) 276-2877

NPI Registry JSON

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1750797445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 INDIANA AVE",
            "address_2": "SUITE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925044562",
            "telephone_number": "951-276-2877",
            "fax_number": "951-276-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 INDIANA AVE",
            "address_2": "SUITE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925044562",
            "telephone_number": "951-276-2877",
            "fax_number": "951-276-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMMY NGUYEN D.D.S., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "951-276-2877",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "57891",
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "57891",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "57891",
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "57891",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melody Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.