Active NPI
Jessica V Nguyen, DDS, MPH
- Dentist
- Bellevue, WA
National Provider Identifier
1780994400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE61048710
- Practice address
- 1050 140TH Ave NE
Bellevue, WA 98005-2972 - Phone
- (425) 373-3030
- Fax
- (206) 652-5216
- NPI assigned
- Oct 15, 2010
- Last updated
- Feb 2, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE61048710 | WA | Primary |
Addresses
Primary practice location
1050 140TH Ave NE
Bellevue, WA 98005-2972
Mailing address
PO Box 3007
Seattle, WA 98114-3007
Phone (206) 788-3757
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161228001931 | CA | Order and Referring Only - Dentist | 0244511558 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE61048710 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643760000000",
"number": "1780994400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3007",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981143007",
"telephone_number": "206-788-3757",
"fax_number": "206-652-5216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 140TH AVE NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980052972",
"telephone_number": "425-373-3030",
"fax_number": "206-652-5216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "JESSICA",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "DDS, MPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-15",
"last_updated": "2022-02-02",
"certification_date": "2022-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE61048710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.