Active NPI
Manuel Phu Nguyen, DDS
- Dentist
- Santa Ana, CA
National Provider Identifier
1720175003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 52657
- Practice address
- 2 Macarthur PL
Suite 700
Santa Ana, CA 92707-5924 - Phone
- (714) 850-3333
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 52657 | CA | Primary |
Addresses
Primary practice location
2 Macarthur PL
Suite 700
Santa Ana, CA 92707-5924
Mailing address
14292 Village Way
Unit 3
Westminster, CA 92683-1506
Phone (714) 902-3764
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160620002399 | CA | Order and Referring Only - Oral Surgery | 0042501108 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720175003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14292 VILLAGE WAY",
"address_2": "UNIT 3",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926831506",
"telephone_number": "714-902-3764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 MACARTHUR PL",
"address_2": "SUITE 700",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927075924",
"telephone_number": "714-850-3333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "MANUEL",
"middle_name": "PHU",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "52657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.