Vivian Phuong Nguyen, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D010263 Issued in AZ

Practice address

22788 E Poco Calle
Queen Creek, AZ 85142-1449

Phone

(773) 220-3979

NPI assigned

Jun 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1487682936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22788 E POCO CALLE",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421449",
            "telephone_number": "773-220-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22788 E POCO CALLE",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421449",
            "telephone_number": "773-220-3979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7040 N Kenton Ave",
            "address_purpose": "LOCATION",
            "city": "Lincolnwood",
            "state": "IL",
            "postal_code": "607122125",
            "country_code": "US",
            "telephone_number": "847-729-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VIVIAN",
        "middle_name": "PHUONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019025837",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D010263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fernanda Newman, RBT
• Annette E Nganje
• Di Nguyen, PHARM. D.
• Thu Hang Nguyen, RPH
• Thy Phuong Nguyen, PHARMD
• Nichols Orthodontics and Aesthetics PLLC
• Trevor Scott Nichols, DMD
• Kylee Rai Nickerson
• Rebecca-Ann Nielsen, RN
• Shelly Nielson, MA

• Dentist in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.