Individual provider Active NPI

Tony N Nguyen, DMD

  • General Practice Dentistry
  • Poplar Bluff, MO
National Provider Identifier
1821787870
Registry record updated Oct 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2026022792 Issued in MO
Practice address
1407 N Westwood Blvd
Poplar Bluff, MO 63901-3315
Phone
(573) 778-3042
Fax
(573) 778-9432
NPI assigned
May 4, 2023
Last updated
Oct 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2026

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 2026022792 MO Primary

Addresses

Primary practice location

1407 N Westwood Blvd
Poplar Bluff, MO 63901-3315

Mailing address

110 S 2ND St
Ellington, MO 63638-9400
Phone (573) 663-2313

Other practice location 1

315 W Mulberry Ste B
Pilot Knob, MO 63663-7883
Phone (573) 546-1001

Other practice location 2

1 Hals Plz Ste B
Piedmont, MO 63957-1631
Phone (573) 223-8902

Other practice location 3

115 W Walnut St
Ellington, MO 63638-9300
Phone (573) 663-3177

Other practice location 4

109 Plum St Ste D
Doniphan, MO 63935-1225
Phone (573) 351-2041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2026022792MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793059200000",
    "number": "1821787870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S 2ND ST",
            "city": "ELLINGTON",
            "state": "MO",
            "postal_code": "636389400",
            "telephone_number": "573-663-2313",
            "fax_number": "573-663-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013315",
            "telephone_number": "573-778-3042",
            "fax_number": "573-778-9432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W Mulberry Ste B",
            "address_purpose": "LOCATION",
            "city": "Pilot Knob",
            "state": "MO",
            "postal_code": "636637883",
            "country_code": "US",
            "telephone_number": "573-546-1001",
            "fax_number": "573-546-1002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Hals Plz Ste B",
            "address_purpose": "LOCATION",
            "city": "Piedmont",
            "state": "MO",
            "postal_code": "639571631",
            "country_code": "US",
            "telephone_number": "573-223-8902",
            "fax_number": "573-223-2141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 W Walnut St",
            "address_purpose": "LOCATION",
            "city": "Ellington",
            "state": "MO",
            "postal_code": "636389300",
            "country_code": "US",
            "telephone_number": "573-663-3177",
            "fax_number": "573-663-3188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Plum St Ste D",
            "address_purpose": "LOCATION",
            "city": "Doniphan",
            "state": "MO",
            "postal_code": "639351225",
            "country_code": "US",
            "telephone_number": "573-351-2041",
            "fax_number": "573-351-2016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TONY",
        "middle_name": "N",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-04",
        "last_updated": "2026-10-27",
        "certification_date": "2026-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2026022792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.