Active NPI
Quoc-Hiep Phan Dao, DENTAL HYGIENIST
- Dental Hygienist
- Garden Grove, CA
National Provider Identifier
1033678487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 31952
- Practice address
- 13691 Cypress St
Garden Grove, CA 92843-3230 - Phone
- (714) 251-3793
- NPI assigned
- Mar 15, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 31952 | CA | Primary |
Addresses
Primary practice location
13691 Cypress St
Garden Grove, CA 92843-3230
Mailing address
13691 Cypress St
Garden Grove, CA 92843-3230
Phone (714) 251-3793
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31952 | Other | CA | DENTAL HYGIENE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 31952 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552608000000",
"number": "1033678487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13691 CYPRESS ST",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928433230",
"telephone_number": "714-251-3793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13691 CYPRESS ST",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928433230",
"telephone_number": "714-251-3793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAO",
"first_name": "QUOC-HIEP",
"middle_name": "PHAN",
"credential": "DENTAL HYGIENIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-15",
"last_updated": "2019-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "31952",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL HYGIENE",
"identifier": "31952",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.