NPIMap

Organization Active NPI

Randy Trung-Quy Nguyen, DDS a Dental Corporation

  • General Practice Dentistry
  • Santa Rosa, CA
National Provider Identifier
1750521365
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43828 Issued in CA
Legal business name
RANDY TRUNG-QUY NGUYEN, DDS A DENTAL CORPORATION
Practice address
526 College Ave
Santa Rosa, CA 95404-4103
Phone
(707) 527-8700
Fax
(707) 527-8134
NPI assigned
Feb 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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

Authorized official

Name
Dr. Randy Trung-Quy Nguyen, DDSNPI 1861552812
Title
President
Phone
(707) 527-8700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 43828 CA Primary

Addresses

Primary practice location

526 College Ave
Santa Rosa, CA 95404-4103

Mailing address

526 College Ave
Santa Rosa, CA 95404-4103
Phone (707) 527-8700

Other identifiers 2

IdentifierTypeStateIssuer
1861552812OtherCANPI
G89559-01OtherCAMEDI-CAL

National Provider Directory

National Provider Directory

Locations

526 College Ave
Santa Rosa, CA 95404
Phone (707) 527-8700

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1750521365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 COLLEGE AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044103",
            "telephone_number": "707-527-8700",
            "fax_number": "707-527-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 COLLEGE AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044103",
            "telephone_number": "707-527-8700",
            "fax_number": "707-527-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDY TRUNG-QUY NGUYEN, DDS A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "TRUNG-QUY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-527-8700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1861552812",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "G89559-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.