Active NPI
Kathleen Huan Pham, D.M.D
- General Practice Dentistry
- Lewisville, TX
National Provider Identifier
1093896409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0021912
- Practice address
- 951 W Main St
Suite a
Lewisville, TX 75067-3515 - Phone
- (972) 434-4300
- Fax
- (972) 360-3294
- NPI assigned
- Oct 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 21912 | TX | |
| General Practice Dentistry | 1223G0001X | 0021912 | TX | Primary |
Addresses
Primary practice location
951 W Main St
Suite a
Lewisville, TX 75067-3515
Mailing address
951 W Main St
Suite a
Lewisville, TX 75067-3515
Phone (972) 434-4300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 181951801 | Medicaid | TX |
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 |
|---|---|---|---|
| 21912 | TX | MD | Dentist |
| 0021912 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kathleen H Pham, DMD, PA | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Lewisville, TX
- NPI 1366523771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655424000000",
"number": "1093896409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "951 W MAIN ST",
"address_2": "SUITE A",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750673515",
"telephone_number": "972-434-4300",
"fax_number": "972-360-3294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "951 W MAIN ST",
"address_2": "SUITE A",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750673515",
"telephone_number": "972-434-4300",
"fax_number": "972-360-3294"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "KATHLEEN",
"middle_name": "HUAN",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-18",
"last_updated": "2022-06-17",
"certification_date": "2022-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "21912",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "0021912",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "181951801",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.