Individual provider Active NPI

Phuong Trang Nguyen, D.D.S.

  • General Practice Dentistry
  • Eureka, CA
National Provider Identifier
1205057692
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
40378 Issued in CA
Practice address
959 Myrtle Ave
Eureka, CA 95501-1219
Phone
(707) 442-7078
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 40378 CA Primary

Addresses

Primary practice location

959 Myrtle Ave
Eureka, CA 95501-1219

Mailing address

9 Silliman St Ste 2
San Francisco, CA 94134-1200
Phone (415) 467-4726

Other practice location 1

9 Silliman St
Suite 2
San Francisco, CA 94134-1200
Phone (415) 467-4726

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

LicenseStateTypeSpecialty
40378CAMDLicensed Psychiatric Technician

Interoperability endpoints

  • Direct secure messaging: phuongdds.nguyen.p1@direct.csvs.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1205057692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 SILLIMAN ST STE 2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941341200",
            "telephone_number": "415-467-4726",
            "fax_number": "415-467-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 MYRTLE AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011219",
            "telephone_number": "707-442-7078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Silliman St",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941341200",
            "country_code": "US",
            "telephone_number": "415-467-4726",
            "fax_number": "415-467-9315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUONG",
        "middle_name": "TRANG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; 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.