Active NPI
William Quyen Doan DO, D.D.S.
- General Practice Dentistry
- Tracy, CA
National Provider Identifier
1093900458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 43527
- Practice address
- 945 Central Ave
Tracy, CA 95376-3950 - Phone
- (209) 836-0443
- Fax
- (209) 836-0490
- NPI assigned
- Sep 10, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 43527 | CA | Primary |
Addresses
Primary practice location
945 Central Ave
Tracy, CA 95376-3950
Mailing address
945 Central Ave
Tracy, CA 95376-3950
Phone (209) 836-0443
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G91480-01 | Other | CA | DENTI-CAL |
| B43527 | Other | CA | DELTA DENTAL STATE GOVT P |
Other names 1
- Mr. Quyen Doan DO
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 |
|---|---|---|---|
| 43527 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tracy Family Dental Center | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Tracy, CA
- NPI 1922214337
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189382400000",
"number": "1093900458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "945 CENTRAL AVE",
"city": "TRACY",
"state": "CA",
"postal_code": "953763950",
"telephone_number": "209-836-0443",
"fax_number": "209-836-0490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 CENTRAL AVE",
"city": "TRACY",
"state": "CA",
"postal_code": "953763950",
"telephone_number": "209-836-0443",
"fax_number": "209-836-0490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DO",
"first_name": "WILLIAM",
"middle_name": "QUYEN DOAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-10",
"last_updated": "2007-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "43527",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTI-CAL",
"identifier": "G91480-01",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL STATE GOVT P",
"identifier": "B43527",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "QUYEN",
"last_name": "DO",
"middle_name": "DOAN",
"prefix": "MR.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tracy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.