Active NPI
Nghia Van Nguyen, DDS
- General Practice Dentistry
- St Louis, MO
National Provider Identifier
1871683789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 015646
- Practice address
- 3546 Gravois Ave
St Louis, MO 63118 - Phone
- (314) 773-3666
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 015646 | MO | Primary |
Addresses
Primary practice location
3546 Gravois Ave
St Louis, MO 63118
Mailing address
3546 Gravois Ave
St Louis, MO 63118
Phone (314) 773-3666
Other names 1
- Nghia Peter Nguyen
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151202000861 | MO | Order and Referring Only - Dentist | 5698075364 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nghia Peter Nguyen DDS PC | General Practice | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Saint Louis, MO
- NPI 1427931898
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871683789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3546 GRAVOIS AVE",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63118",
"telephone_number": "314-773-3666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3546 GRAVOIS AVE",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63118",
"telephone_number": "314-773-3666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "NGHIA",
"middle_name": "VAN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "015646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NGHIA",
"last_name": "NGUYEN",
"middle_name": "PETER",
"credential": "DDS",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in St Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.