Eric Phan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DS044803 Issued in PA

Practice address

4940 Linglestown Rd
Harrisburg, PA 17112-9515

Phone

(717) 901-7045

NPI assigned

Jul 16, 2024

Sex

Male

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

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.

• CDG Harrisburg LLC

  • General Practice Dentistry
  • Harrisburg, PA
  • NPI 1457151235
  NPD
• Colonial Dental Group PC

  • General Practice Dentistry
  • Harrisburg, PA
  • NPI 1720115462
  NPD (past)

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1104664945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 BOAS ST APT 910",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171021321",
            "telephone_number": "703-869-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 LINGLESTOWN RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171129515",
            "telephone_number": "717-901-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS044803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Peterson
• Mary Petrini
• Riley Pett, DPM
• Kelli Pettersson, LCSW
• Mary Pfeiffer, LCSW
• Ngan Ngoc Phan, NA
• Matthew Robert Phelan, CRNP
• Joanna Rae Phillippy
• Denise Phillips, M.ED., LBS
• Ethan Brady Phillips

• Dentist in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.