Individual provider Active NPI

John Nguyen Dentel, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Detroit, MI
National Provider Identifier
1962638874
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
4301116212 Issued in MI
Practice address
3901 Beaubien St FL 4
Detroit, MI 48201-2119
Phone
(313) 745-5538
NPI assigned
Jun 5, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 4301116212 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3901 Beaubien St FL 4
Detroit, MI 48201-2119

Mailing address

3901 Beaubien St FL 4
Detroit, MI 48201-2119
Phone (313) 745-5538

Other practice location 1

20 York St # T-209
Yale New Haven Hospital
New Haven, CT 06510-3220
Phone (203) 688-2259

Other practice location 2

20 York St # T-209
Yale New Haven Hospital
New Haven, CT 06510-3220
Phone (203) 688-2259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220428000917 FL Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 1355610296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Cardiac Surgery
Education
Wayne State University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital District 659 clinicians

Practice addresses (Care Compare)

1150 N 35TH Ave
Suite 490
Hollywood, FL 33021-5423
Phone (954) 265-3437

4651 Sheridan St
Suite 150
Hollywood, FL 33021-3443
Phone (954) 265-6331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Mar 21, 2022 Accepting new patients
South Broward Hospital District Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Mar 21, 2022 Accepting new patients
South Broward Hospital District Current Accepting new patients

Locations

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

4651 Sheridan St
Ste 150
Pembroke Park, FL 33021
Phone (954) 265-6331

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1962638874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST FL 4",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST FL 4",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-5538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York St # T-209",
            "address_2": "Yale New Haven Hospital",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-2259",
            "fax_number": "203-688-5599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 York St # T-209",
            "address_2": "Yale New Haven Hospital",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-2259",
            "fax_number": "203-688-5599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENTEL",
        "first_name": "JOHN",
        "middle_name": "NGUYEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-05",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "4301116212",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.