Individual provider Active NPI

Hieu Pham, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1013458942
Registry record updated Aug 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
060465 Issued in NY
Practice address
131 Essex St FL 2
New York, NY 10002-2370
Phone
(646) 681-7006
NPI assigned
Mar 10, 2017
Last updated
Aug 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN1857851 MA
General Practice Dentistry 1223G0001X 35498 TX
General Practice Dentistry 1223G0001X 060465 NY Primary

Addresses

Primary practice location

131 Essex St FL 2
New York, NY 10002-2370

Mailing address

131 Essex St FL 2
New York, NY 10002-2370

Other practice location 1

102 Pearl St
Braintree, MA 02184
Phone (781) 356-3030

Other practice location 2

825 E Rundberg Ln Ste A1
Austin, TX 78753-4809
Phone (512) 837-0200

Other practice location 3

345 E 24th St
New York, NY 10010-4020
Phone (212) 998-9800

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
060465NYMDGeneral Practice Dentistry
35498TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Dental PLLC CurrentSince Aug 18, 2024 Accepting new patients
42 North Dental Care, LLC Past Accepting new patients

Locations

131 Essex St
Fl 2
New York, NY 10002
Phone (646) 663-7633

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723852800000",
    "number": "1013458942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 ESSEX ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100022370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 ESSEX ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100022370",
            "telephone_number": "646-681-7006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Pearl St",
            "address_purpose": "LOCATION",
            "city": "Braintree",
            "state": "MA",
            "postal_code": "02184",
            "country_code": "US",
            "telephone_number": "781-356-3030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "825 E Rundberg Ln Ste A1",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787534809",
            "country_code": "US",
            "telephone_number": "512-837-0200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "345 E 24th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100104020",
            "country_code": "US",
            "telephone_number": "212-998-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "HIEU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-10",
        "last_updated": "2024-08-17",
        "certification_date": "2024-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1857851",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35498",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "060465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2024; 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.