MEDICARE: TIMOTHY NGUYEN DDS

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	122300000X	Dentist	2026023631	MO

General Provider Information

NPI Number	:	1891643904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY NGUYEN DDS

Provider Business Mailing Address
First Line	:	829 NW DONOVAN RD APT 308
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64086-1749
Country	:	US
Telephone Number	:	816-772-2808
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 SWIFT ST
Second Line	:
City	:	NORTH KANSAS CITY
State	:	MO
Zip	:	64116
Country	:	US
Telephone Number	:	816-471-2911
Fax Number	:

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

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	06/01/2026

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