Active NPI
Cuong Quoc Phan, D.D.S.
- Dentist
- Fresno, TX
National Provider Identifier
1922447010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 29113
- Practice address
- 12125 Highway 6
Suite D
Fresno, TX 77545-8843 - Phone
- (281) 431-8909
- NPI assigned
- Jun 21, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | 29113 | TX | Primary |
Addresses
Primary practice location
12125 Highway 6
Suite D
Fresno, TX 77545-8843
Mailing address
9411 Kari Springs CT
Houston, TX 77040-7647
Phone (832) 798-0141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29113 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minhly Duy Nguyen DDS PA | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Fresno, TX
- NPI 1033237656
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371772800000",
"number": "1922447010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9411 KARI SPRINGS CT",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770407647",
"telephone_number": "832-798-0141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12125 HIGHWAY 6",
"address_2": "SUITE D",
"city": "FRESNO",
"state": "TX",
"postal_code": "775458843",
"telephone_number": "281-431-8909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "CUONG",
"middle_name": "QUOC",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-21",
"last_updated": "2013-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "29113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.