Michelle Pham

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS042721 Issued in PA

Practice address

116 S George St
York, PA 17401-1474

Phone

(717) 801-4846

Fax

(717) 854-0377

NPI assigned

Jun 12, 2020

Sex

Female

Sole proprietor

No

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

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Family First Health Corporation

  dba Family First Health - Columbia Dental

  • Federally Qualified Health Center (FQHC)
  • Columbia, PA
  • NPI 1407487382
  NPD (past)
• Family First Health Corporation

  • Community/Retail Pharmacy
  • York, PA
  • NPI 1699573758
  NPD (past)

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1104441377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S GEORGE ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174011474",
            "telephone_number": "717-801-4846",
            "fax_number": "717-854-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S GEORGE ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174011474",
            "telephone_number": "717-801-4846",
            "fax_number": "717-854-0377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Bloomfield Dr Ste 211",
            "address_purpose": "LOCATION",
            "city": "Lititz",
            "state": "PA",
            "postal_code": "175437789",
            "country_code": "US",
            "telephone_number": "717-340-0478",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1275 York Rd Ste 17",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173257565",
            "country_code": "US",
            "telephone_number": "717-337-9400",
            "fax_number": "717-420-5909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "430 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "PA",
            "postal_code": "175121295",
            "country_code": "US",
            "telephone_number": "717-356-2233",
            "fax_number": "717-356-2234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1230 High St",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "PA",
            "postal_code": "173311127",
            "country_code": "US",
            "telephone_number": "717-632-9052",
            "fax_number": "717-632-0846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS042721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Petrucci
• Christine Petrucci, LDN
• Elizabeth Pezoa
• Maryellen Estevez Pfeiffer, D.O.
• Altina T Phaire, M.D
• Sarah Thi Pham
• Olivia A Phan, PHARM.D.
• Thanh Huong Phan, RPH
• Donna Marie Phillips, PT
• Jade Si-Yuan Phillips, MD

• General Practice Dentistry in York, PA
• Providers in York, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.