NPIMap

Organization Active NPI

An Nguyen DDS Prof Corp

Doing business as 29 Palms Dental

  • General Practice Dentistry
  • Twentynine Palms, CA
National Provider Identifier
1871897389
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
56731 Issued in CA
Legal business name
AN NGUYEN DDS PROF CORP
Doing business as
29 Palms Dental
Practice address
73666 Joshua Dr.
Twentynine Palms, CA 92277
Phone
(760) 865-0544
Fax
(888) 877-5510
NPI assigned
Dec 28, 2010
Last updated
Nov 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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

Authorized official

Name
Mr. An V Nguyen, DDSNPI 1104963750
Title
Dentist
Phone
(760) 865-0544

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 56731 CA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 59641 CA
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 57500 CA

Addresses

Primary practice location

73666 Joshua Dr.
Twentynine Palms, CA 92277

Mailing address

73666 Joshua Dr.
Twentynine Palms, CA 92277
Phone (760) 865-0544

Other identifiers 3

IdentifierTypeStateIssuer
1104963750OtherCAINDIVIDUAL DENTAL PROVIDERS
1780801969OtherCAINDIVIDUAL DENTAL PROVIDER
1942538160OtherCAINDIVIDUAL DENTAL PROVIDER

Other names 1

  • 29 Palms Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353456000000",
    "number": "1871897389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73666 JOSHUA DR.",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "92277",
            "telephone_number": "760-865-0544",
            "fax_number": "888-877-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73666 JOSHUA DR.",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "92277",
            "telephone_number": "760-865-0544",
            "fax_number": "888-877-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AN NGUYEN DDS PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-28",
        "last_updated": "2012-11-21",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "AN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "760-865-0544",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56731",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59641",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL DENTAL PROVIDERS",
            "identifier": "1104963750",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL DENTAL PROVIDER",
            "identifier": "1780801969",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL DENTAL PROVIDER",
            "identifier": "1942538160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "29 Palms Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Twentynine Palms, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; 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.