Organization Active NPI

Dentists of Royal Palm, PA

  • Dentist
  • Royal Palm Beach, FL
National Provider Identifier
1114585577
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DENTISTS OF ROYAL PALM, PA
Practice address
11151 Southern Blvd Ste 110
Royal Palm Beach, FL 33411-4255
Phone
(561) 246-6371
NPI assigned
May 31, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Authorized official

Name
Dr. Minh Pham, DDS
Title
Owner/General Dentist
Phone
(561) 246-6371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

11151 Southern Blvd Ste 110
Royal Palm Beach, FL 33411-4255

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8890

Other names 1

  • Dentists of Royal Palm Doing business as

National Provider Directory

National Provider Directory

Locations

11151 Southern Blvd
Ste 110
Royal Palm Beach, FL 33411
Phone (561) 246-6371

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": "1559260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1114585577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11151 SOUTHERN BLVD STE 110",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334114255",
            "telephone_number": "561-246-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTS OF ROYAL PALM, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-31",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "MINH",
        "authorized_official_title_or_position": "OWNER/GENERAL DENTIST",
        "authorized_official_telephone_number": "561-246-6371",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentists of Royal Palm",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dentists of Royal Palm",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Royal Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.