Active NPI
Quynh Diem Nguyen, DMD
- Dentist
- Clackamas, OR
National Provider Identifier
1376541433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D7195
- Practice address
- 12845 SE 93Rd Ave
Clackamas, OR 97015 - Phone
- (503) 794-1900
- Fax
- (503) 794-2778
- NPI assigned
- Jul 12, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D7195 | OR | Primary |
Addresses
Primary practice location
12845 SE 93Rd Ave
Clackamas, OR 97015
Mailing address
12845 SE 93Rd Ave
Clackamas, OR 97015
Phone (503) 794-1900
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
| License | State | Type | Specialty |
|---|---|---|---|
| D7195 | OR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunnybrook Family Dental LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Happy Valley, OR
- NPI 1821203522
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418860800000",
"number": "1376541433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12845 SE 93RD AVE",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "97015",
"telephone_number": "503-794-1900",
"fax_number": "503-794-2778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12845 SE 93RD AVE",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "97015",
"telephone_number": "503-794-1900",
"fax_number": "503-794-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "QUYNH DIEM",
"name_prefix": "Mrs.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-12",
"last_updated": "2014-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D7195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.