NPIMap

Organization Active NPI

Loc B Pham DDS & Tracy T Nguyen DDS Professional Corp

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1104911940
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
46515 Issued in CA
Legal business name
LOC B PHAM DDS & TRACY T NGUYEN DDS PROFESSIONAL CORP
Practice address
2344 McKee Road
Suite 50
San Jose, CA 95116-1616
Phone
(408) 251-0118
Fax
(408) 251-0119
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Loc B Pham, DDSNPI 1992916852
Title
Dentist Secer Secretary
Phone
(408) 251-0118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 46515 CA Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 46508 CA

Addresses

Primary practice location

2344 McKee Road
Suite 50
San Jose, CA 95116-1616

Mailing address

2344 McKee Road
Suite 50
San Jose, CA 95116-1616
Phone (408) 251-0118

Other names 1

  • TK Dental Practice Doing business as

National Provider Directory

National Provider Directory

Locations

2344 McKee Rd
Ste 50
San Jose, CA 95116
Phone (408) 251-0118

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104911940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2344 MCKEE ROAD",
            "address_2": "SUITE 50",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161616",
            "telephone_number": "408-251-0118",
            "fax_number": "408-251-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2344 MCKEE ROAD",
            "address_2": "SUITE 50",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161616",
            "telephone_number": "408-251-0118",
            "fax_number": "408-251-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOC B PHAM DDS & TRACY T NGUYEN DDS PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "LOC",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DENTIST SECER SECRETARY",
        "authorized_official_telephone_number": "408-251-0118",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46515",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46508",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TK Dental Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.