Ticole Nguyen DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31936 Issued in TX

Legal business name

TICOLE NGUYEN DDS PLLC

Practice address

5210 S State Highway 360 # 500
Grand Prairie, TX 75052-8307

Phone

(469) 616-0488

Fax

(866) 892-0774

NPI assigned

Sep 7, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Ticole Nguyen, DDS

Title

Owner

Phone

(469) 616-0488

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1831617034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 S STATE HIGHWAY 360 # 500",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528307",
            "telephone_number": "469-616-0488",
            "fax_number": "866-892-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5210 S STATE HIGHWAY 360 # 500",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528307",
            "telephone_number": "469-616-0488",
            "fax_number": "866-892-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TICOLE NGUYEN DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "TICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-616-0488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1104277169",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.