Individual provider Active NPI

Paul Truong Nguyen, DENTIST

  • General Practice Dentistry
  • Tustin, CA
National Provider Identifier
1174955488
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS64255 Issued in CA
Practice address
661 W 1St St Ste a
Tustin, CA 92780-2939
Phone
(714) 665-9890
Fax
(714) 665-9891
NPI assigned
Aug 8, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DENT.DE.60668006 WA
General Practice Dentistry 1223G0001X D008816 AZ
General Practice Dentistry 1223G0001X DDS64255 CA Primary

Addresses

Primary practice location

661 W 1St St Ste a
Tustin, CA 92780-2939

Mailing address

661 W 1St St Ste G
Tustin, CA 92780-2939
Phone (714) 665-9890

Other practice location 1

9918 Katella Ave Ste A-C
Anaheim, CA 92804-6465
Phone (714) 644-9494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250901000695 CA Practitioner - Dentist 1850685157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

661 W 1St St
Suite G
Tustin, CA 92780-2939

PO Box
Suite 1240
Westminster, CA 92684

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D008816AZMDGeneral Practice Dentistry
DDS64255CAMDGeneral Practice Dentistry
DENT.DE.60668006WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Families Together of Orange County CurrentSince Jul 18, 2025 Accepting new patients
Families Together of Orange County CurrentSince Jul 18, 2025 Accepting new patients
Families Together of Orange County PastSince Jan 21, 2024 Accepting new patients
Universa Medica Healh ,Inc PastSince Nov 7, 2025 Accepting new patients

Locations

9918 Katella Ave
Ste Ac
Anaheim, CA 92804
Phone (714) 644-9494

661 W 1st St
Tustin, CA 92780
Phone (714) 665-9890

661 W 1st St
Ste A
Tustin, CA 92780
Phone (714) 665-1175

661 W 1st St
Ste G
Tustin, CA 92780
Phone (714) 665-9890

Organizations & group practices 4

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": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1174955488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST STE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-9890",
            "fax_number": "714-665-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST STE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-9890",
            "fax_number": "714-665-9891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9918 Katella Ave Ste A-C",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928046465",
            "country_code": "US",
            "telephone_number": "714-644-9494",
            "fax_number": "714-644-9894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PAUL",
        "middle_name": "TRUONG",
        "credential": "DENTIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-08",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DENT.DE.60668006",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D008816",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS64255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.