Phong Nguyen, ADT

Primary specialty

Advanced Practice Dental TherapistTaxonomy code 125K00000X

License

DT78 Issued in MN

Practice address

1213 E Franklin Ave
Minneapolis, MN 55404

Phone

(612) 872-8086

Fax

(612) 872-8547

NPI assigned

Mar 10, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1528509510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 E FRANKLIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042923",
            "telephone_number": "612-872-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 E FRANKLIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "612-872-8086",
            "fax_number": "612-872-8547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4243 4th Ave S",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554092113",
            "country_code": "US",
            "telephone_number": "612-821-2025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHONG",
        "credential": "ADT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-10",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MN",
            "license": "H9909",
            "primary": false
        },
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "MN",
            "license": "DT78",
            "primary": false
        },
        {
            "code": "125K00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Dental Therapist",
            "state": "MN",
            "license": "DT78",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Ngoc Nguyen, PHARMD
• Ngoc Thoa Nguyen
• Nha P Nguyen, MD
• Niki N Nguyen, PHARMD
• Phan Quynh Anh Nguyen, D.P.T
• Quoc Thong Nguyen, DMD
• Richard Nguyen, MD
• Ryan Nguyen, PHARMD
• Sean Nguyen, MD
• Summer Nguyen

• Advanced Practice Dental Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Advanced Practice Dental Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.