Provider Demographics
NPI:1598753618
Name:NGUYEN, DAN TD (MD)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:TD
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 24106
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73124-0106
Mailing Address - Country:US
Mailing Address - Phone:202-258-1455
Mailing Address - Fax:405-643-4682
Practice Address - Street 1:1000 N LINCOLN BLVD STE 4000
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-3252
Practice Address - Country:US
Practice Address - Phone:405-271-4912
Practice Address - Fax:405-271-3091
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK336762085R0202X, 2085N0700X
DC319392085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200794250AMedicaid
PA1014302410001Medicaid
OK696270OtherMEDICARE