Active NPI
Lien Phuong Thi Nguyen
- Dentist
- Garden Grove, CA
National Provider Identifier
1124807532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 109425
- Practice address
- 12221 Homestead PL
Garden Grove, CA 92840-5718 - Phone
- (703) 894-7849
- NPI assigned
- Sep 25, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 109425 | CA | Primary |
Addresses
Primary practice location
12221 Homestead PL
Garden Grove, CA 92840-5718
Mailing address
12221 Homestead PL
Garden Grove, CA 92840-5718
Phone (703) 894-7849
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 |
|---|---|---|---|
| 109425 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1124807532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12221 HOMESTEAD PL",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928405718",
"telephone_number": "703-894-7849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12221 HOMESTEAD PL",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928405718",
"telephone_number": "703-894-7849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "LIEN PHUONG",
"middle_name": "THI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-25",
"last_updated": "2023-09-25",
"certification_date": "2023-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "109425",
"primary": true
}
],
"identifiers": [],
"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 Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.