Individual provider Active NPI

My Pang Kou Vang, M

  • Dental Therapist
  • West St Paul, MN
National Provider Identifier
1033623822
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental TherapistTaxonomy code 125J00000X
License
DT84 Issued in MN
Practice address
1590 Robert St S
West St Paul, MN 55118-3403
Phone
(651) 300-0949
NPI assigned
Dec 1, 2017
Last updated
Dec 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Therapist 125J00000X DT84 MN Primary

Addresses

Primary practice location

1590 Robert St S
West St Paul, MN 55118-3403

Mailing address

386 Winifred St E
Saint Paul, MN 55107-2424
Phone (651) 226-5110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DT84MNMDDental Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr My Pang Kou Vang DDS, PLLC Current Accepting new patients
Accesspoint Dental LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1033623822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "386 WINIFRED ST E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551072424",
            "telephone_number": "651-226-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 ROBERT ST S",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551183403",
            "telephone_number": "651-300-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG",
        "first_name": "MY PANG",
        "middle_name": "KOU",
        "credential": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-01",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "MN",
            "license": "DT84",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West St Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.