Individual provider Active NPI

Tony Nguyen, DDS

  • Dentist
  • Fort Worth, TX
National Provider Identifier
1962667774
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
24160 Issued in TX
Practice address
2815 Azle Ave
Fort Worth, TX 76106-5106
Phone
(817) 624-0222
Fax
(817) 624-0221
NPI assigned
Jul 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 24160 TX Primary

Addresses

Primary practice location

2815 Azle Ave
Fort Worth, TX 76106-5106

Mailing address

2815 Azle Ave
Fort Worth, TX 76106-5106
Phone (817) 624-0222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160106001048 TX Order and Referring Only - DentistPractitioner - Dentist 8628370798

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1962667774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 AZLE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761065106",
            "telephone_number": "817-624-0222",
            "fax_number": "817-624-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 AZLE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761065106",
            "telephone_number": "817-624-0222",
            "fax_number": "817-624-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TONY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "24160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.