Active NPI
Jacqueline Nguyen, DMD
- Dentist
- Chicago, IL
National Provider Identifier
1912575143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.033151
- Practice address
- 1114 S Clinton St
Chicago, IL 60607-4434 - Phone
- (312) 254-9798
- NPI assigned
- Jun 14, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 019.033151 | IL | Primary |
Addresses
Primary practice location
1114 S Clinton St
Chicago, IL 60607-4434
Mailing address
1130 S Michigan Ave Apt 2610
Chicago, IL 60605-2331
Phone (317) 514-8536
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019.033151 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623628800000",
"number": "1912575143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 S MICHIGAN AVE APT 2610",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606052331",
"telephone_number": "317-514-8536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1114 S CLINTON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606074434",
"telephone_number": "312-254-9798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "JACQUELINE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-14",
"last_updated": "2021-06-14",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.033151",
"primary": true
}
],
"identifiers": [],
"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 Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.