Mai Phuong Nguyen Dang, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5315241265 Issued in MI

Practice address

204 W Main St
Fremont, MI 49412-1181

Phone

(231) 924-1800

NPI assigned

Apr 13, 2023

Last updated

Aug 24, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Touro Un College of Osteopathic Medicine, Vallejo, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1437845443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W MAIN ST",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494121181",
            "telephone_number": "231-924-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN DANG",
        "first_name": "MAI PHUONG",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-13",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5315241265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "204 W Main St",
            "city": "Fremont",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494121181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnguyendang1263387@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "204 W Main St",
            "city": "Fremont",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494121181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Newaygo County General Hospital Association (Gerber Memorial CRNA)
• Newaygo County General Hospital Association (Corewell Health Gerber Hospital Pediatrics & Walk-In Clinic - Fremont)
• Newaygo County General Hospital Association (Corewell Health Gerber Hospital Professional)
• Newaygo County Resa
• Newaygo Medical Care Facility
• Alan L Nieboer, GNP
• Christopher Callis Niquette, DDS
• Julie A Norris, M.D.
• David Wayne Oosting, O.D.
• Ashly Aleese Ott, PA-C

• Pediatrics Physician in Fremont, MI
• Providers in Fremont, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.