Individual provider Active NPI

Thien Nguyen

  • General Practice Dentistry
  • Bemidji, MN
National Provider Identifier
1780374751
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D15339 Issued in MN
Practice address
2219 Paul Bunyan Dr NW Ste 6-7
Bemidji, MN 56601-6188
Phone
(925) 525-9226
NPI assigned
May 11, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D15339 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2219 Paul Bunyan Dr NW Ste 6-7
Bemidji, MN 56601-6188

Mailing address

1900 S Campus Ave Apt 22E
Ontario, CA 91761-5463
Phone (925) 525-9226

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
D15339MNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1780374751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 S CAMPUS AVE APT 22E",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917615463",
            "telephone_number": "925-525-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 PAUL BUNYAN DR NW STE 6-7",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566016188",
            "telephone_number": "925-525-9226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THIEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-11",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D15339",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; 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.