Active NPI
Stephanie Phuong-Dinh Nguyen, DMD
- Dentist
- Puyallup, WA
National Provider Identifier
1447985189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE61326850
- Practice address
- 702 S Hill Park Dr Ste 201
Puyallup, WA 98373-1426 - Phone
- (855) 433-6825
- NPI assigned
- Jul 18, 2022
- 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 | DE61326850 | WA | Primary |
Addresses
Primary practice location
702 S Hill Park Dr Ste 201
Puyallup, WA 98373-1426
Mailing address
6821 Udall PL SE Apt H301
Auburn, WA 98092-9632
Phone (503) 998-4193
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 |
|---|---|---|---|
| DE61326850 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willamette Dental Group, P.C. | Dentist | 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.
-
- Dentist
- Puyallup, WA
- NPI 1174448534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658102400000",
"number": "1447985189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6821 UDALL PL SE APT H301",
"city": "AUBURN",
"state": "WA",
"postal_code": "980929632",
"telephone_number": "503-998-4193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 S HILL PARK DR STE 201",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983731426",
"telephone_number": "855-433-6825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "STEPHANIE",
"middle_name": "PHUONG-DINH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-18",
"last_updated": "2022-07-18",
"certification_date": "2022-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE61326850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.