Individual provider Active NPI

Thomas Nguyen, DDS

  • Dentist
  • Riverside, CA
National Provider Identifier
1821726126
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
107781 Issued in CA
Practice address
4371 Latham St
Riverside, CA 92501-1706
Phone
(833) 867-4642
Fax
(360) 462-2757
NPI assigned
Aug 13, 2022
Last updated
Apr 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 107781 CA Primary

Addresses

Primary practice location

4371 Latham St
Riverside, CA 92501-1706

Mailing address

2084 Wild Woods
Upland, CA 91786-8469
Phone (714) 725-5281

Other practice location 1

6000 N Figueroa St
Los Angeles, CA 90042-4232
Phone (866) 616-9344

Other practice location 2

1450 E Holt Ave
Pomona, CA 91767-5822
Phone (909) 469-9016

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
I20221202002756 CA Practitioner - Dentist 8921477555 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107781CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Arroyo Vista Family Health Foundation CurrentSince Sep 1, 2022 Accepting new patients
Arroyo Vista Family Health Foundation CurrentSince Sep 1, 2022 Accepting new patients

Locations

2411 N Broadway
Los Angeles, CA 90031
Phone (323) 254-5291

6000 N Figueroa St
Los Angeles, CA 90042
Phone (323) 254-5221

Interoperability endpoints

  • Direct secure messaging: thomas.nguyen.p1@direct.arroyovista.nextgenshare.com
  • Direct secure messaging: thomas.nguyen.p3@direct.parktreechc.nextgenshare.com

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, 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": "1660348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1821726126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2084 WILD WOODS",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868469",
            "telephone_number": "714-725-5281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4371 LATHAM ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011706",
            "telephone_number": "833-867-4642",
            "fax_number": "360-462-2757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6000 N Figueroa St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900424232",
            "country_code": "US",
            "telephone_number": "866-616-9344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1450 E Holt Ave",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917675822",
            "country_code": "US",
            "telephone_number": "909-469-9016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THOMAS",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-13",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "107781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.