Individual provider Active NPI

Phuc-Hau Bich Nguyen, D.M.D.

  • General Practice Dentistry
  • Gainesville, FL
National Provider Identifier
1831303759
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN16796 Issued in FL
Practice address
3661 NW 64TH LN
Gainesville, FL 32653-8870
Phone
(352) 359-1716
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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 DN16796 FL Primary

Addresses

Primary practice location

3661 NW 64TH LN
Gainesville, FL 32653-8870

Mailing address

3661 NW 64TH LN
Gainesville, FL 32653-8870
Phone (352) 359-1716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161010001725 FL Order and Referring Only - DentistPractitioner - Dentist 4880982727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN16796FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1831303759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3661 NW 64TH LN",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326538870",
            "telephone_number": "352-359-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 NW 64TH LN",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326538870",
            "telephone_number": "352-359-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUC-HAU",
        "middle_name": "BICH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.