Active NPI
Hiep Duy Pham
- General Practice Dentistry
- Round Rock, TX
National Provider Identifier
1093208696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 34190
- Practice address
- 4554 Miraval Loop
Round Rock, TX 78665-3929 - Phone
- (949) 232-0236
- NPI assigned
- Jun 8, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 34190 | TX | Primary |
Addresses
Primary practice location
4554 Miraval Loop
Round Rock, TX 78665-3929
Mailing address
4554 Miraval Loop
Round Rock, TX 78665-3929
Phone (949) 232-0236
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34190 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HQ Dental Texas PLLC | General Practice | Current | Accepting new patients |
| Bliss Dental PLLC | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1093208696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4554 MIRAVAL LOOP",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786653929",
"telephone_number": "949-232-0236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4554 MIRAVAL LOOP",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786653929",
"telephone_number": "949-232-0236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "HIEP",
"middle_name": "DUY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-08",
"last_updated": "2020-10-28",
"certification_date": "2020-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "34190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.