Healthcare Provider Details

I. General information

NPI: 1740980440
Provider Name (Legal Business Name): RICHARD NGUYEN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2023
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 128TH ST
URBANDALE IA
50323-1816
US

IV. Provider business mailing address

5031 TIMBERWOOD CT
WEST DES MOINES IA
50265-5456
US

V. Phone/Fax

Practice location:
  • Phone: 515-827-0913
  • Fax:
Mailing address:
  • Phone: 402-301-4383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDDS-10421
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: