Phuoc Quang Phi, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DE00007819 Issued in WA

Practice address

5523 Rainier Ave S
Seattle, WA 98118-2440

Phone

(206) 760-8171

Fax

(206) 760-1595

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1518046010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5523 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182440",
            "telephone_number": "206-760-8171",
            "fax_number": "206-760-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5523 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182440",
            "telephone_number": "206-760-8171",
            "fax_number": "206-760-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHI",
        "first_name": "PHUOC",
        "middle_name": "QUANG",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00007819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5036553",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER",
            "identifier": "849461",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER",
            "identifier": "148473",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PROVIDER",
            "identifier": "PH5843",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lee Mark Phelps, DC
• Linda Louise Phelps, LAC, EAMP, DIPL AC
• Matthew Duke Phelps, M.D.
• Phenopath Laboratories PLLC
• Sonh Phetsomphou, RN
• Jamie Michele Phifer, M.D.
• Philip a Walczak DDS PLLC
• Philip D Welch M.D.
• Philip Farish Psychotherapy PLLC
• Philip G Lindsay MD Inc PS

• Dentist in Seattle, WA
• Providers in Seattle, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.