Individual provider Active NPI

Julia Nguyen

  • Endodontics
  • Prairie Village, KS
National Provider Identifier
1972913374
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
61726 Issued in KS
Practice address
7301 Mission Rd Ste 317
Prairie Village, KS 66208
Phone
(913) 236-7668
NPI assigned
May 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 019030264 IL
Endodontics 1223E0200X 2019033972 MO
Endodontics 1223E0200X 61726 KS Primary

Addresses

Primary practice location

7301 Mission Rd Ste 317
Prairie Village, KS 66208

Mailing address

9641 N Ambassador Dr Unit 2407
Kansas City, MO 64154-7269

Other practice location 1

808 E Woodfield Rd Ste 300
Schaumburg, IL 60173-4836
Phone (847) 517-8330

Other practice location 2

801 S Paulina St Rm 304G
UIC Department of Endodontics
Chicago, IL 60612-7210
Phone (312) 996-7514

Other practice location 3

808 E Woodfield Rd Ste 300
Schaumburg, IL 60173-4836
Phone (847) 517-8330

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
019030264ILMDEndodontist
61726KSMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Jwwdental LLC Endodontics Past Accepting new patients
Adam S Colombo, DDS Endodontics PastSince Oct 13, 2019 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1972913374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9641 N AMBASSADOR DR UNIT 2407",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641547269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 MISSION RD STE 317",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "66208",
            "telephone_number": "913-236-7668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 E Woodfield Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601734836",
            "country_code": "US",
            "telephone_number": "847-517-8330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 S Paulina St Rm 304G",
            "address_2": "UIC Department of Endodontics",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127210",
            "country_code": "US",
            "telephone_number": "312-996-7514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "808 E Woodfield Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601734836",
            "country_code": "US",
            "telephone_number": "847-517-8330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JULIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-07",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "019030264",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MO",
            "license": "2019033972",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "KS",
            "license": "61726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Village, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.