Phung Kim Nguyen, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

44749 Issued in CA

Practice address

2114 Senter
#25
San Jose, CA 95112

Phone

(408) 279-2114

Fax

(408) 279-1828

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1891714754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 SENTER",
            "address_2": "#25",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95112",
            "telephone_number": "408-279-2114",
            "fax_number": "408-279-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 SENTER",
            "address_2": "#25",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95112",
            "telephone_number": "408-279-2114",
            "fax_number": "408-279-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUNG",
        "middle_name": "KIM",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "44749",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44749",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "421592283",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phi Tien Nguyen, PHARMD
• Philip An Nguyen, PA-C
• Phillip Son Nguyen, RN
• Phuc Nguyen, DDS
• Phuc Van Nguyen, DDS
• Phung Kim Nguyen, FNP
• Phuocai Nguyen, M.A.
• Phuong Hoang Nguyen, MD
• Phuong Thao Nguyen, MD
• Phuong Thi Nguyen, ASW

• Dentist in San Jose, CA
• Providers in San Jose, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.

Verify at the official NPI Registry.