Individual provider Active NPI

Toan Nguyen

  • Dentist
  • San Antonio, TX
National Provider Identifier
1780384891
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40559 Issued in TX
Practice address
22106 US Highway 281 N Ste 103
San Antonio, TX 78258-7652
Phone
(210) 714-5710
NPI assigned
Mar 7, 2023
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 40559 TX Primary

Addresses

Primary practice location

22106 US Highway 281 N Ste 103
San Antonio, TX 78258-7652

Mailing address

9372 Wood Duck Dr
Fort Worth, TX 76118-7784
Phone (682) 583-6208

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
40559TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Dental of Stone Oak Dentist PastSince Jul 21, 2024 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, 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": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1780384891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9372 WOOD DUCK DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761187784",
            "telephone_number": "682-583-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22106 US HIGHWAY 281 N STE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782587652",
            "telephone_number": "210-714-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TOAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-07",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "40559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.