Individual provider Active NPI

Chanel Nguyen, DMD

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1932768884
Registry record updated Jul 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7228 Issued in NV
Practice address
4380 Blue Diamond Rd Ste 102
Las Vegas, NV 89139-7786
Phone
(702) 425-4424
NPI assigned
Jun 12, 2019
Last updated
Jul 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7228 NV Primary

Addresses

Primary practice location

4380 Blue Diamond Rd Ste 102
Las Vegas, NV 89139-7786

Mailing address

4380 Blue Diamond Rd Ste 102
Las Vegas, NV 89139-7786
Phone (702) 425-4424

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
7228NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Dental Services General Practice PastSince Jul 25, 2019 Accepting new patients
Watanabe Diamond Dental Group, Professional Corporation General Practice PastSince Jul 25, 2019 Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicproxy.et1079.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563062400000",
    "number": "1932768884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 BLUE DIAMOND RD STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891397786",
            "telephone_number": "702-425-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 BLUE DIAMOND RD STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891397786",
            "telephone_number": "702-425-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CHANEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2019; 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.