PHONG NGUYEN (NPI# 1528509510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528509510 |
| Entity Type | Individual |
| Full Name | PHONG NGUYEN |
| Credential | ADT |
| Practice Address |
1213 E Franklin Ave Minneapolis MN 55404 |
| Mailing Address |
1213 E Franklin Ave Minneapolis MN 55404-2923 |
| Practice Telephone | 6128728086 |
| Practice Fax Number | 6128728547 |
| Mailing Telephone | 6128728086 |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2019-03-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 124Q00000X | Dental Hygienist | H9909 | MN | Dental Providers |
| N | 125J00000X | Dental Therapist | DT78 | MN | Dental Providers |
| Y | 125K00000X | Advanced Practice Dental Therapist | DT78 | MN | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4243 4th Ave S, Minneapolis, MN 554092113 | 6128212025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649591140 | Phong Lan Nguyen | Dentist | 1923 E 7th St # 120, Austin, TX 78702-3419 | 2010-06-18 |
| 1003135732 | Phong The Nguyen | Physical Therapist | 18002 Dunoon Bay Point Ct, Cypress, TX 77429-5276 | 2010-05-20 |
| 1659424836 | Phong Dong Nguyen | Internal Medicine | 6800 Little River Turnpike, Annandale, VA 22003 | 2007-01-19 |
| 1699836726 | Phong Quang Nguyen | Internal Medicine | 1860 Town Center Dr Ste 130, Reston, VA 20190-5898 | 2006-12-13 |
| 1346268778 | Phong T Nguyen | Family Medicine | 31895 Opal Dr, Winchester, CA 92596-9081 | 2006-07-17 |
| 1013935246 | Phong Nguyen | Dentist | 5430 Powers Center Pt, Ste. 110, Colorado Springs, CO 80920-7154 | 2006-07-17 |
| 1952345506 | Phong Hoai Nguyen | Internal Medicine | 2430 North Fry Road, #100, Houston, TX 77084 | 2006-06-15 |
| 1710972195 | Phong Quoc Nguyen | Optometrist | 2402 S Azusa Ave, West Covina, CA 91792-1512 | 2005-09-13 |
| 1356968515 | Phong Duc Nguyen | Behavior Technician | 5312 Bolsa Ave Ste 105, Huntington Beach, CA 92649-1060 | 2020-07-02 |
| 1316502297 | Phong Duy Nguyen | Nurse Practitioner | 4150 Clement St, San Francisco, CA 94121-1563 | 2019-05-06 |
| Street Address |
1213 E FRANKLIN AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366402174 | Kari Rabie | Family Medicine | 1213 E Franklin Ave, Minneapolis, MN 55404-2923 | 2006-03-24 |
| 1346704830 | Nikita Boyd | Nurse Practitioner | 1213 E Franklin Ave, Minneapolis, MN 55404-2923 | 2019-01-29 |
| 1538648811 | Tara Lynn Mccullough | Nurse Practitioner | 1213 E Franklin Ave, Minneapolis, MN 55404-2923 | 2018-08-08 |
| 1164920963 | Nacc Tribal Health Services | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1213 E Franklin Ave, Minneapolis, MN 55404-2923 | 2018-01-26 |
| 1386152833 | Nacc Medication Assisted Recovery Services | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1213 E Franklin Ave, Minneapolis, MN 55404-2923 | 2018-01-18 |
| 1083154140 | Patrick Parker | Marriage & Family Therapist | 1213 E Franklin Ave, Minneapolis, MN 55404-2923 | 2017-03-08 |
| 1427590272 | Crystal Milan | Nurse Practitioner | 1213 E Franklin Ave, Minneapolis, MN 55404 | 2016-11-10 |
| 1013389170 | Mary Raukar | Family Medicine | 1213 E Franklin Ave, Minneapolis, MN 55404-2923 | 2015-10-28 |
| 1760897375 | Emily Fowler | Counselor | 1213 E Franklin Ave, Minneapolis, MN 55404 | 2014-06-23 |
| 1417372319 | Marcey Mae Smith | Social Worker | 1213 E Franklin Ave, Minneapolis, MN 55404-2923 | 2014-02-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1760969125 | Bethany Karen Kenny | Registered Nurse | 910 E 26th St Ste 200, Minneapolis, MN 55404 | 2018-07-27 |
| 1225535701 | Karissa Dougherty | Nurse Practitioner | 2200 E Franklin Ave # 199, Minneapolis, MN 55404 | 2018-04-10 |
| 1891299491 | Guidance Home Health Care LLC | Home Health | 2529 Nicollet Avenue 202b, Minneapolis, MN 55404 | 2018-03-20 |
| 1770085490 | Bright Future Counseling Service, LLC | Counselor | 912 E. 24th St., Suite B215, Minneapolis, MN 55404 | 2018-03-08 |
| 1346754298 | Juba Pharmacy Inc | Pharmacy | 1926 Chicago Ave S, Minneapolis, MN 55404 | 2017-11-29 |
| 1629597323 | Kira Larson Fieldstrom | Social Worker | 2400 Blaisdell Ave., Minneapolis, MN 55404 | 2017-09-13 |
| 1770008930 | Nicole Lynn Sparks | Social Worker | 2445 Park Avenue, Minneapolis, MN 55404 | 2017-08-09 |
| 1639612765 | Cosmo Home Healthcare Services, L.L.C. | Home Health | 2219 Oakland Ave S, Suite 104, Minneapolis, MN 55404 | 2016-11-21 |
| Find all providers in zip 55404 | ||||
| Taxonomy Code | 125K00000X |
| Grouping | Dental Providers |
| Classification | Advanced Practice Dental Therapist |
| An Advanced Practice Dental Therapist is: (1) A dental therapist who has completed additional training beyond basic dental therapy education and provides dental services in accordance with state advanced practice dental therapist laws or statutes; or (2) A dental hygienist with a graduate degree in advanced dental therapy prepared for independent and interdependent decision making and direct accountability for clinical judgment across the dental health care continuum. The individual has been authorized by the relevant state board or a tribal entity to provide services under the remote supervision of a dentist. The functions of the advanced practice dental therapist vary based on the needs of the dentist, the educational preparation of the advanced practice dental therapist and state dental practice acts and regulations. |
| Notes: Source: Summarized from Minnesota Statute 150A.106. [7/1/2012: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124483656 | Tanu Dhoopar | Advanced Practice Dental Therapist | 3152 Minnehaha Ave, Minneapolis, MN 55406-1934 | 2015-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578117438 | Christina Marie Hubred | Advanced Practice Dental Therapist | Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2019-07-30 |
| 1144733130 | Lydia J Diekmann | Advanced Practice Dental Therapist | 2711 Broadway Ave Ste A00, Slayton, MN 56172-1313 | 2017-11-13 |
| 1073872503 | Brieanne Kelsey Borntrager | Advanced Practice Dental Therapist | 13899 Hwy 13 S Frnt Rd, Savage, MN 55378-2135 | 2012-05-03 |
| 1023541695 | Carley Banks | Advanced Practice Dental Therapist | 1575 20th St Nw, Faribault, MN 55021 | 2017-04-10 |
| 1033642947 | Lauren Johnson | Advanced Practice Dental Therapist | 1575 20th St Nw, Suite 102, Faribault, MN 55021-2930 | 2017-04-07 |
| 1063953032 | Ashley Hueman | Advanced Practice Dental Therapist | 973 Skyline Dr Sw, Rochester, MN 55902-1220 | 2017-03-10 |
| 1548631187 | Kaitlin Siewert | Advanced Practice Dental Therapist | 520 Main Street, Hawley, MN 56549 | 2015-10-08 |
| City | MINNEAPOLIS |
| Zip Code | 55404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.