Phuc Quang Nguyen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

104196 Issued in CA

Practice address

21 W Duarte Rd
Arcadia, CA 91007-6969

Phone

(626) 821-9970

NPI assigned

Aug 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1780239475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 LOS GATOS DR",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917891722",
            "telephone_number": "714-234-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W DUARTE RD",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910076969",
            "telephone_number": "626-821-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUC",
        "middle_name": "QUANG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-08",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica CHI Nguyen, MD
• Karen Nguyen
• Mark Nguyen, PHARM.D.
• Michael Sitai Nguyen, DDS
• Ngoc-CHI Thi Nguyen, D.D.S.
• Quoc Hoai Nguyen, COTA/L
• Taylor Duong Nguyen
• Tiffany Diep Nguyen, OD
• Tina Nguyen
• Vicky Hang Nguyen

• General Practice Dentistry in Arcadia, CA
• Providers in Arcadia, 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 Dec 30, 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.