Individual provider Active NPI

Cham Phoung Nguyen, DDS

  • Dentist
  • Pasadena, TX
National Provider Identifier
1154536514
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21829 Issued in TX
Practice address
905 Southmore
Pasadena, TX 77502
Phone
(713) 473-7223
Fax
(713) 473-7206
NPI assigned
May 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 21829 TX Primary

Addresses

Primary practice location

905 Southmore
Pasadena, TX 77502

Mailing address

905 Southmore
Pasadena, TX 77502
Phone (713) 473-7223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231204002261 TX Order and Referring Only - DentistPractitioner - Dentist 4789972142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154536514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 SOUTHMORE",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "77502",
            "telephone_number": "713-473-7223",
            "fax_number": "713-473-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 SOUTHMORE",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "77502",
            "telephone_number": "713-473-7223",
            "fax_number": "713-473-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CHAM",
        "middle_name": "PHOUNG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "21829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.