Long Nguyen D.D.S. a Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45159 Issued in CA

Legal business name

LONG NGUYEN D.D.S. A DENTAL CORPORATION

Doing business as

Sierra Dental Practice

Practice address

9290 Sierra College Blvd Ste 300
Roseville, CA 95661-5919

Phone

(916) 788-8450

Fax

(916) 788-8452

NPI assigned

May 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Long Bao Nguyen, D.D.S.NPI 1801990130

Title

Ceo

Phone

(916) 788-8450

Specialties & licenses 1

Addresses

Other names 1

• Sierra Dental Practice Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Long Bao Nguyen, DDS

  • Dentist
  • Roseville, CA
  • NPI 1801990130
  NPD (past) Authorized official
• Anhthu Deana Phan, D.D.S.

  • General Practice Dentistry
  • Roseville, CA
  • NPI 1629336417
  NPD (past)

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

{
    "created_epoch": "1179619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649488727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9290 SIERRA COLLEGE BLVD STE 300",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615919",
            "telephone_number": "916-788-8450",
            "fax_number": "916-788-8452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9290 SIERRA COLLEGE BLVD STE 300",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615919",
            "telephone_number": "916-788-8450",
            "fax_number": "916-788-8452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG NGUYEN D.D.S. A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "LONG",
        "authorized_official_middle_name": "BAO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-788-8450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sierra Dental Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Genevieve A Logie, MD
• Travis Loidolt, DO
• Ryan James Lokkesmoe
• Jamie Lee Lombrana, MFT TRAINEE
• Evan G Lomen, DDM
• Theresa Adelaide Longo, MD
• Longs Drug Stores California Inc (Longs Drug Store)
• Longs Drug Stores California LLC (CVS Pharmacy #09958)
• Longs Drug Stores California LLC (CVS Pharmacy #09993)
• Nancy Anne Longyear, F.N.P.

• General Practice Dentistry in Roseville, CA
• Providers in Roseville, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.