Annie Phuong Thao Dinh Nguyen, PHARM.D., BCPS

Primary specialty

PharmacistTaxonomy code 183500000X

License

76450 Issued in CA

Practice address

22101 Moross Rd
Detroit, MI 48236-2148

Phone

(313) 343-3760

NPI assigned

Mar 12, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Phuong Thao Dinh Nguyen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1992330781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 MAXWELL AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671267",
            "telephone_number": "858-201-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "313-343-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANNIE",
        "middle_name": "PHUONG THAO DINH",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., BCPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302044687",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "76450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHUONG",
            "last_name": "NGUYEN",
            "middle_name": "THAO DINH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lenyie Ngbogbara
• Julie Ngo
• Marilyn Nah Ngundam, NP -C, PMHNP-BC
• Nam Tran Nguyen Lam, DO
• Joseph Nguyen-Dinh
• Felix Nguyen, MD
• Henry Nguyen, DO
• James Hoang Quoc Nguyen
• Julie M Nguyen, M.D.
• Le Huy Nguyen, DDS

• Pharmacist in Detroit, MI
• Providers in Detroit, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.