Pauline Lee Phan, Professional Dental Corp.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PAULINE LEE PHAN, PROFESSIONAL DENTAL CORP.

Doing business as

Dental Arts

Practice address

11703 Edinger Ave
Fountain Valley, CA 92708-1208

Phone

(714) 775-1934

Fax

(714) 775-7743

NPI assigned

Mar 23, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Pauline Lee Phan, DDSNPI 1912118480

Title

President

Phone

(714) 775-1934

Specialties & licenses 1

Addresses

Other names 1

• Dental Arts Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pauline Lee Phan, D.D.S.

  • General Practice Dentistry
  • Fountain Valley, CA
  • NPI 1912118480
  NPD (past) Authorized official

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1053773689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11703 EDINGER AVE.",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-775-1934",
            "fax_number": "714-775-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11703 EDINGER AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927081208",
            "telephone_number": "714-775-1934",
            "fax_number": "714-775-7743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULINE LEE PHAN, PROFESSIONAL DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-775-1934",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Arts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tushar Pratap Patel, M.D.
• Veeral Patel, MD
• Pathway Medical Group, Inc
• Clifton Patterson Sr.
• Paul Maistros, M.D.,Inc.
• Pauni Medical Inc
• Marlene Sarahi Pavia
• Payam Farjoodi MD Inc
• Margarita Paz Garcia
• Peak State Wellness a Jared Young DC Corporation

• General Practice Dentistry in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.