Active NPI
Tien V Luong, D.D.S.
- General Practice Dentistry
- Garden Grove, CA
National Provider Identifier
1629277199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 48746
- Practice address
- 12879 Chapman Ave
Garden Grove, CA 92840-4100 - Phone
- (714) 740-2051
- Fax
- (714) 840-2051
- NPI assigned
- Jul 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 48746 | CA | Primary |
Addresses
Primary practice location
12879 Chapman Ave
Garden Grove, CA 92840-4100
Mailing address
12879 Chapman Ave
Garden Grove, CA 92840-4100
Phone (714) 740-2051
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
| License | State | Type | Specialty |
|---|---|---|---|
| 48746 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416441600000",
"number": "1629277199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12879 CHAPMAN AVE",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928404100",
"telephone_number": "714-740-2051",
"fax_number": "714-840-2051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12879 CHAPMAN AVE",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928404100",
"telephone_number": "714-740-2051",
"fax_number": "714-840-2051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUONG",
"first_name": "TIEN",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-16",
"last_updated": "2014-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "48746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.