Daniel Phan Nguyen, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12018 Issued in OR

Practice address

13180 SE 172ND Ave Ste 146
Happy Valley, OR 97086-9654

Phone

(503) 353-6568

NPI assigned

Apr 1, 2024

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Happy Valley Modern Dentistry, PC

  dba Happy Valley Modern Dentistry

  • General Practice Dentistry
  • Happy Valley, OR
  • NPI 1740921527
  NPD

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1225889975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13376 SE SCENIC RIDGE DR",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970157534",
            "telephone_number": "503-454-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13180 SE 172ND AVE STE 146",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970869654",
            "telephone_number": "503-353-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DANIEL",
        "middle_name": "PHAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "12018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Negus, D.C.
• Blake A Nelson, PA-C
• Heidi Neubig, B.S.
• New Seasons Market - Happy Valley
• Newstart Community Development
• Michelle Yen Nguyen
• Phuong Tan My Nguyen
• Victoria Nguyen, PHARM.D
• Lynn Marie Nishida, RPH
• Johnny Nolan, DO

• Dentist in Happy Valley, OR
• Providers in Happy Valley, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.