Individual provider Active NPI

Dat Quoc Nguyen, D.D.S.

  • General Practice Dentistry
  • Rosemead, CA
National Provider Identifier
1477654036
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
46660 Issued in CA
Practice address
9008 Garvey Ave.
Ste B and C
Rosemead, CA 91770-3360
Phone
(626) 280-6733
Fax
(626) 280-7906
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 46660 CA Primary

Addresses

Primary practice location

9008 Garvey Ave.
Ste B and C
Rosemead, CA 91770-3360

Mailing address

14282 Brookhurst St Ste 6
Garden Grove, CA 92843-4663
Phone (714) 531-6487

Other practice location 1

14282 Brookhurst St Ste 6
Garden Grove, CA 92843-4663
Phone (714) 531-6487

Other identifiers 1

IdentifierTypeStateIssuer
B46660-01OtherCADENTI-CAL PROVIDER NUMBER

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

LicenseStateTypeSpecialty
46660CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dat Quoc Nguyen D.D.S., Inc. General Practice PastSince Jul 17, 2021 Accepting new patients
Dat Nguyen D.D.S. General Practice PastSince Jul 17, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1477654036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14282 BROOKHURST ST STE 6",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434663",
            "telephone_number": "714-531-6487",
            "fax_number": "714-531-6488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9008 GARVEY AVE.",
            "address_2": "STE B AND C",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917703360",
            "telephone_number": "626-280-6733",
            "fax_number": "626-280-7906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14282 Brookhurst St Ste 6",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928434663",
            "country_code": "US",
            "telephone_number": "714-531-6487",
            "fax_number": "714-531-6488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DAT",
        "middle_name": "QUOC",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL PROVIDER NUMBER",
            "identifier": "B46660-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosemead, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.