Individual provider Active NPI

Nikki Tram Nguyen, DMD

  • General Practice Dentistry
  • Charleston, SC
National Provider Identifier
1902176860
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8937 Issued in SC
Practice address
949 E Estates Blvd Apt 306
Charleston, SC 29414-5669
Phone
(469) 288-0464
NPI assigned
Jan 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/Technologist 246ZE0600X 1738 TX
General Practice Dentistry 1223G0001X 8937 SC Primary

Addresses

Primary practice location

949 E Estates Blvd Apt 306
Charleston, SC 29414-5669

Mailing address

949 E Estates Blvd Apt 306
Charleston, SC 29414-5669
Phone (469) 288-0464

Other practice location 1

25 Highland Park Vlg Ste 100-225
Dallas, TX 75205-2789
Phone (214) 460-4457

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
8937SCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1902176860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 E ESTATES BLVD APT 306",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145669",
            "telephone_number": "469-288-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 E ESTATES BLVD APT 306",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145669",
            "telephone_number": "469-288-0464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Highland Park Vlg Ste 100-225",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752052789",
            "country_code": "US",
            "telephone_number": "214-460-4457",
            "fax_number": "214-975-1312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "NIKKI",
        "middle_name": "TRAM",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "TX",
            "license": "1738",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • 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.