Individual provider Active NPI

Trang Thi Quynh Nguyen, DDS

  • Pediatric Dentistry
  • Raleigh, NC
National Provider Identifier
1477943231
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
10139 Issued in NC
Practice address
2800 Wakefield Pines Drive Suite 110
Raleigh, NC 27614
Phone
(919) 570-0180
Fax
(919) 570-0280
NPI assigned
Feb 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X 10139 NC Primary

Addresses

Primary practice location

2800 Wakefield Pines Drive Suite 110
Raleigh, NC 27614

Mailing address

2800 Wakefield Pines Drive Suite 110
Raleigh, NC 27614
Phone (919) 570-0180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20171021000042 NC Practitioner - Dentist 6406122357 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10139NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson & Morris PLLC Pediatric Dentistry CurrentSince Oct 1, 2023 Accepting new patients
Dr. Cameron & Associates of Raleigh I, PLLC Pediatric Dentistry CurrentSince Dec 10, 2023 Accepting new patients
Ryan, James, Wiles, Patel & Olsen LLP PastSince Aug 1, 2017 Accepting new patients

Locations

2800 Wakefield Pines Dr
Ste 110
Raleigh, NC 27614
Phone (919) 570-0180

Organizations & group practices 4

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": "1422835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1477943231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 WAKEFIELD PINES DRIVE SUITE 110",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27614",
            "telephone_number": "919-570-0180",
            "fax_number": "919-570-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 WAKEFIELD PINES DRIVE SUITE 110",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27614",
            "telephone_number": "919-570-0180",
            "fax_number": "919-570-0280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TRANG",
        "middle_name": "THI QUYNH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-02",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "10139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.