Individual provider Active NPI

Thuan Anthony Nguyen, DDS

  • Dentist
  • Garden Grove, CA
National Provider Identifier
1780776922
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41290 Issued in CA
Practice address
9451 Nichols Dr
Garden Grove, CA 92841-5144
Phone
(714) 300-8767
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 41290 CA Primary

Addresses

Primary practice location

9451 Nichols Dr
Garden Grove, CA 92841-5144

Mailing address

PO Box 1276
Garden Grove, CA 92842-1276
Phone (714) 300-8767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190925001036 CA Practitioner - Oral SurgeryPractitioner - Maxillofacial SurgeryPractitioner - Dentist 8022348648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41290CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thuan Huu Nguyen DDS Inc Dentist CurrentSince Nov 1, 2019 Accepting new patients
Anthony Nguyen DDS Inc Past Accepting new patients

Locations

12372 Garden Grove Blvd
Ste A
Garden Grove, CA 92843
Phone (714) 797-5535

Organizations & group practices 2

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": "1602633600000",
    "number": "1780776922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1276",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928421276",
            "telephone_number": "714-300-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9451 NICHOLS DR",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928415144",
            "telephone_number": "714-300-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THUAN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.