Active NPI
An Nguyen
- General Practice Dentistry
- Fountain Valley, CA
National Provider Identifier
1992157804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 100315
- Practice address
- 11100 Warner Ave Ste 312
Fountain Valley, CA 92708-7512 - Phone
- (714) 364-0774
- NPI assigned
- Jul 5, 2016
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 100315 | CA | Primary |
Addresses
Primary practice location
11100 Warner Ave Ste 312
Fountain Valley, CA 92708-7512
Mailing address
19231 Monte Vista Dr
Saratoga, CA 95070-6217
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160824000349 | CA | Order and Referring Only - Dentist | 8729373162 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100315 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644019200000",
"number": "1992157804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19231 MONTE VISTA DR",
"city": "SARATOGA",
"state": "CA",
"postal_code": "950706217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11100 WARNER AVE STE 312",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927087512",
"telephone_number": "714-364-0774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "AN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-05",
"last_updated": "2022-02-05",
"certification_date": "2022-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "100315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fountain Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.