Individual provider Active NPI

John C. Nguyen, DMD

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1811443252
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS101050 Issued in CA
Practice address
1515 E Alluvial Ave Ste 107
Fresno, CA 93720-3832
Phone
(559) 298-3800
Fax
(559) 298-5936
NPI assigned
Aug 26, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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 DDS101050 CA Primary

Addresses

Primary practice location

1515 E Alluvial Ave Ste 107
Fresno, CA 93720-3832

Mailing address

1515 E Alluvial Ave Ste 107
Fresno, CA 93720-3832
Phone (559) 298-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20160909001636 WI Order and Referring Only - DentistPractitioner - Dentist 1254627771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS101050CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
John C Nguyen DMD, Inc. General Practice CurrentSince Aug 10, 2025 Accepting new patients

Locations

1515 E Alluvial Ave
Ste 107
Fresno, CA 93720
Phone (559) 298-3800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1811443252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E ALLUVIAL AVE STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203832",
            "telephone_number": "559-298-3800",
            "fax_number": "559-298-5936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E ALLUVIAL AVE STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203832",
            "telephone_number": "559-298-3800",
            "fax_number": "559-298-5936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JOHN",
        "middle_name": "C.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-26",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS101050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.