Individual provider Active NPI

Cuong Quoc Nguyen, DMD, MPH

  • Dentist
  • El Segundo, CA
National Provider Identifier
1053797456
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS103209 Issued in CA
Practice address
390 N. Pacific Coast Hwy, Suite 1150
El Segundo, CA 90245
Phone
(310) 322-1814
Fax
(267) 769-1596
NPI assigned
Aug 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X DS040485 PA
Dentist 122300000X DDS103209 CA Primary

Addresses

Primary practice location

390 N. Pacific Coast Hwy, Suite 1150
El Segundo, CA 90245

Mailing address

390 N. Pacific Coast Hwy, Suite 1150
El Segundo, CA 90245
Phone (310) 322-1814

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS103209CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cuong Nguyen, DMD, MPH, a Professional Dental Corporation CurrentSince Apr 20, 2025 Accepting new patients
Resources for Human Development, Inc. Past Accepting new patients
Family Practice & Counseling Services Network, Inc. Past Accepting new patients

Locations

390 N Pacific Coast Hwy
Ste 1150
El Segundo, CA 90245
Phone (310) 322-1814

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1053797456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 N. PACIFIC COAST HWY, SUITE 1150",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "90245",
            "telephone_number": "310-322-1814",
            "fax_number": "267-597-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N. PACIFIC COAST HWY, SUITE 1150",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "90245",
            "telephone_number": "310-322-1814",
            "fax_number": "267-769-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CUONG",
        "middle_name": "QUOC",
        "name_prefix": "Dr.",
        "credential": "DMD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-07",
        "last_updated": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "PA",
            "license": "DS040485",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS103209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.