PHONG NGUYEN ADT
NPI 1528509510
Advanced Practice Dental Therapist in Minneapolis, MN

Q: What is Phong Nguyen's NPI number?

The NPI number for Phong Nguyen is 1528509510. It was assigned to this individual provider in the NPPES registry on March 10, 2017.

Q: What is Phong Nguyen's specialty?

The primary specialty registered for this NPI is Advanced Practice Dental Therapist with taxonomy code 125K00000X.

Q: When was this NPI record last updated?

The NPPES record for Phong Nguyen was last updated on March 28, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 10, 2017

1213 E FRANKLIN AVE, MINNEAPOLIS, MN 55404(612) 872-8086(612) 872-8547 Get Directions Write a Review

NPPES record last updated: March 28, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Phong Nguyen Adt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHONG NGUYEN ADT (NPI 1528509510) is an individual advanced practice dental therapist in Minneapolis, Minnesota, licensed in Minnesota (DT78) and active in the NPI registry since March 2017. He maintains a secondary practice location in Minneapolis.

NPPES Registry Identity

NPI1528509510

Entity TypeIndividualMale

Primary Taxonomy125K00000X

Provider Legal NamePHONG NGUYENCredential: ADT

Location Address1213 E FRANKLIN AVEMinneapolis, MN 55404

Mailing Address1213 E Franklin AveMinneapolis, MN 55404-2923 · (612) 872-8086

Phone(612) 872-8086

Fax(612) 872-8547

Sole ProprietorNo

Enumeration DateMarch 10, 2017

Last NPPES UpdateMarch 28, 2019

✔ NPI 1528509510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyAdvanced Practice Dental TherapistDental Providers

Taxonomy Code125K00000X

License✔ Licensed in MN · DT78

Definition

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.

Also ListedDental HygienistTaxonomy 124Q00000X · License H9909 (MN)

Also ListedDental TherapistTaxonomy 125J00000X · License DT78 (MN)

1213 E FRANKLIN AVE, Minneapolis, MN 55404

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Secondary Practice Location 1

Location 14243 4th Ave SMinneapolis, MN 55409-2113 · Phone (612) 821-2025

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY RAUKAR M.D.

Family Medicine