Individual provider Active NPI

Thuan Nguyen, D.D.S.

  • Pediatric Dentistry
  • Chicago, IL
National Provider Identifier
1851627731
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
021002601 Issued in IL
Practice address
5342 S Archer Ave
Chicago, IL 60632
Phone
(773) 284-8540
NPI assigned
Oct 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DEN.00203390 CO
Endodontics 1223E0200X 021002625 IL
Pediatric Dentistry 1223P0221X DEN.00303390 CO
Pediatric Dentistry 1223P0221X 12012141A IN
Pediatric Dentistry 1223P0221X 021002601 IL Primary

Addresses

Primary practice location

5342 S Archer Ave
Chicago, IL 60632

Mailing address

2606 W 99TH St
Evergreen Park, IL 60805-3641
Phone (347) 703-2299

Other practice location 1

7863 Broadway Ste 111
Merrillville, IN 46410-5530
Phone (219) 769-6636

Other practice location 2

7891 Broadway Ste C
Merrillville, IN 46410-5556
Phone (219) 736-2273

Other practice location 3

140 Market St
3rd Floor
Paterson, NJ 07505-1471
Phone (973) 742-4200

Other practice location 4

2250 S Parker Rd Ste 150
Denver, CO 80231-3481
Phone (303) 595-5454

Other identifiers 1

IdentifierTypeStateIssuer
1851627731OtherILTHUAN NGUYEN

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
DEN.00203390COMDEndodontist
021002625ILMDEndodontist
DEN.00303390COMDPediatric Dentist
021002601ILMDPediatric Dentist
12012141AINMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Dental Center of Northwest Indiana Inc Pediatric Dentistry Past Accepting new patients
Archer Dental Specialist Inc Past Accepting new patients
All Family Dental & Braces, LLC. Pediatric Dentistry Past Accepting new patients
Aurora Village Modern Dentistry, LLP Past Accepting new patients
Premier Dental Group PC Past Accepting new patients

Organizations & group practices 5

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": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1851627731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 W 99TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053641",
            "telephone_number": "347-703-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5342 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60632",
            "telephone_number": "773-284-8540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7863 Broadway Ste 111",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464105530",
            "country_code": "US",
            "telephone_number": "219-769-6636",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7891 Broadway Ste C",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464105556",
            "country_code": "US",
            "telephone_number": "219-736-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "140 Market St",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Paterson",
            "state": "NJ",
            "postal_code": "075051471",
            "country_code": "US",
            "telephone_number": "973-742-4200",
            "fax_number": "973-742-4997",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2250 S Parker Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802313481",
            "country_code": "US",
            "telephone_number": "303-595-5454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THUAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-27",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "DEN.00203390",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "021002625",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "DEN.00303390",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12012141A",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "021002601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THUAN NGUYEN",
            "identifier": "1851627731",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.