Trang M Nguyen, D.D.S.
Individual provider Active NPI Dentist · Mendota, CA
NPI 1205960200 · NPPES record last updated May 21, 2015
Key facts
- NPI
- 1205960200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 42199 (CA)
- Practice address
- 33500 W California Ave
Mendota, CA 93640-9703 - Phone
- (559) 274-4155
- NPI assigned
- Mar 14, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160802002146 | CA | Order and Referring Only - Dentist |
6204120041 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 42199 | CA | Yes |
Addresses
Primary practice location
33500 W California Ave
Mendota, CA 93640-9703
Mailing address
80 Main Street
Los Altos, CA 94022
Phone (650) 559-0120
Other providers in Mendota, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.