MEDICARE: DR. DAN TD NGUYEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	33676	OK
2	2085N0700X	Neuroradiology Physician	33676	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598753618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAN TD NGUYEN MD

Provider Business Mailing Address
First Line	:	PO BOX 24106
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73124-0106
Country	:	US
Telephone Number	:	202-258-1455
Fax Number	:	405-643-4682

Provider Business Practice Location Address
First Line	:	1000 N LINCOLN BLVD STE 4000
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-3252
Country	:	US
Telephone Number	:	405-271-4912
Fax Number	:	405-271-3091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	09/03/2025

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