Individual provider Active NPI

Thu Huong Nguyen, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1861686479
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019026962 Issued in IL
Practice address
5324 N Elston Ave
Chicago, IL 60630-1611
Phone
(773) 584-1622
NPI assigned
Aug 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019026962 IL Primary

Addresses

Primary practice location

5324 N Elston Ave
Chicago, IL 60630-1611

Mailing address

5324 N Elston Ave
Chicago, IL 60630-1611
Phone (773) 584-1622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160323001402 IL Order and Referring Only - DentistPractitioner - Dentist 4183921869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Abba Dental Care Current Accepting new patients
Shaddai Dental Care Current Accepting new patients
Rapha Dental Care Dentist Past Accepting new patients

Locations

4725 W Fullerton Ave
Chicago, IL 60639
Phone (773) 252-5757

5324 N Elston Ave
Chicago, IL 60630
Phone (773) 584-1622

Organizations & group practices 3

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": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1861686479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5324 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301611",
            "telephone_number": "773-584-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5324 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301611",
            "telephone_number": "773-584-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THU",
        "middle_name": "HUONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.