Jefferey Pham, D.D.S

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

63830 Issued in CA

Practice address

7812 Warner Ave
Huntington Beach, CA 92647-4700

Phone

(714) 375-3222

Fax

(714) 375-3223

NPI assigned

Sep 12, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1033510771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7812 WARNER AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926474700",
            "telephone_number": "714-375-3222",
            "fax_number": "714-375-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7812 WARNER AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926474700",
            "telephone_number": "714-375-3222",
            "fax_number": "714-375-3223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15701 Spar St",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928435353",
            "country_code": "US",
            "telephone_number": "714-823-0854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JEFFEREY",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-12",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63830",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "63830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daphne Pham
• Derrick Tuan Pham, D.D.S
• Duy Quoc Pham, PHARMD
• Hang Pham
• Ho Phong Nguyen Xuan Pham, MD
• John Pham
• John Quoc Pham
• Johnny Duy Pham
• Krystal Hong-Quyen Pham, D.D.S.
• Long Kim Pham

• Oral and Maxillofacial Surgery (Dentist) in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.