Huy Pham, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D107077 Issued in CA

Practice address

5150 Graves Ave Ste 12E
San Jose, CA 95129-5015

Phone

(408) 253-4150

Fax

(408) 253-1979

NPI assigned

Feb 13, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Huy Pham Dental Corp.

  • Periodontics
  • San Jose, CA
  • NPI 1528719556
  NPD Authorized official
• Keith M Cooper DDS Inc

  • Prosthodontics
  • San Jose, CA
  • NPI 1386249829
  NPD
• Bancroft Dental Care

  • Dentist
  • San Leandro, CA
  • NPI 1659725240
  NPD (past)

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

{
    "created_epoch": "1613174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1063005726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 GRAVES AVE STE 12E",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951295015",
            "telephone_number": "408-253-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 GRAVES AVE STE 12E",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951295015",
            "telephone_number": "408-253-4150",
            "fax_number": "408-253-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "HUY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-13",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "D107077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hien Quy Pham, RPH
• Hien Tai Pham, PHARMD
• Hien Thi Pham, M.D
• Hoan-My Pham
• Hoang H Pham, MD
• Huy Dang Pham
• Jacqueline L Pham, DDS
• Jennifer Doan-Khanh Pham, MSW
• Jennifer Thu Pham, PHARM.D.
• Jillian Hy Pham

• Periodontics in San Jose, CA
• Providers in San Jose, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.