Individual provider Active NPI

Hailey Q Nguyen, DMD

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1790151017
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D10346 Issued in OR
Practice address
10535 NE Glisan St
Suite 301
Portland, OR 97220-4077
Phone
(503) 444-2824
NPI assigned
Aug 20, 2015
Last updated
Aug 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D10346 OR Primary

Addresses

Primary practice location

10535 NE Glisan St
Suite 301
Portland, OR 97220-4077

Mailing address

6146 NE Beech St
Portland, OR 97213-3226
Phone (971) 270-6686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20151027000297 OR Order and Referring Only - DentistPractitioner - Dentist 8628387024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D10346ORMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1790151017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6146 NE BEECH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133226",
            "telephone_number": "971-270-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 NE GLISAN ST",
            "address_2": "SUITE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204077",
            "telephone_number": "503-444-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "HAILEY",
        "middle_name": "Q",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.