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PHONG LY DDS
NPI 1790131761
Dentist in Coon Rapids, MN

Active since May 10, 2016PECOS Enrolled
9920 FOLEY BLVD NW STE 110, COON RAPIDS, MN 55433(763) 377-2110 Get Directions Write a Review

NPPES record last updated: November 12, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 12, 2025, Aug 6, 2019, Apr 11, 2017 and 1 more (4 updates tracked since 2016).

About Phong Ly Dds NPPES

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

PHONG LY DDS (NPI 1790131761) is an individual dentist in Coon Rapids, Minnesota, licensed in Minnesota (D13699) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790131761
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NamePHONG LYCredential: DDS
Location Address9920 FOLEY BLVD NW STE 110Coon Rapids, MN 55433-5216
Mailing Address9920 Foley Blvd Nw Ste 110Coon Rapids, MN 55433-5216 · (763) 317-1166
Phone(763) 377-2110
Sole ProprietorNo
Enumeration DateMay 10, 2016
Last NPPES UpdateNovember 12, 20254 updates tracked since enumeration
NPPES CertifiedNovember 12, 2025
✔ NPI 1790131761 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MN · D13699
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
9920 FOLEY BLVD NW STE 110, Coon Rapids, MN 55433
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phong Ly Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55433 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

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

MAWATA KAMARA
Dental Hygienist
9920 FOLEY BLVD NW STE 110
COON RAPIDS, MN 55433
Anoka County (763) 317-1166
BENJAMINE ASUNCION SOTO
Dentist (General Practice)
9920 FOLEY BLVD NW STE 110
MINNEAPOLIS, MN 55433
Anoka County (763) 317-1166
PL DENTAL SC
Clinic/Center (Dental)
9920 FOLEY BLVD NW STE 110
COON RAPIDS, MN 55433
Anoka County (763) 317-1166

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phong Ly's NPI number?

The NPI number for Phong Ly is 1790131761. It was assigned to this individual provider in the NPPES registry on May 10, 2016.

Where is Phong Ly located?

Phong Ly practices at 9920 Foley Blvd NW Ste 110, Coon Rapids, MN 55433. The listed phone number is (763) 377-2110.

What is Phong Ly's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Phong Ly enrolled in Medicare?

Yes. Phong Ly is registered in the Medicare PECOS enrollment system.

What insurance does Phong Ly accept?

Health plans from Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and HRI Dental & Vision and 3 other insurers list Phong Ly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Phong Ly was last updated on November 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.