Individual provider Active NPI

Nghi Pham, D.M.D

  • Dentist
  • La Place, LA
National Provider Identifier
1114610359
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7574 Issued in LA
Practice address
393 Belle Terre Blvd
La Place, LA 70068-2433
Phone
(985) 652-8767
NPI assigned
Jun 2, 2023
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7574 LA Primary

Addresses

Primary practice location

393 Belle Terre Blvd
La Place, LA 70068-2433

Mailing address

4559 Hickerson St
New Orleans, LA 70127-4103
Phone (504) 289-7783

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20241015002108 LA Order and Referring Only - DentistPractitioner - Dentist 4789116732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7574LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama at Birmingham PastSince Jun 1, 2023 Accepting new patients

Networks

  • LA PPO C-SNP

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1114610359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4559 HICKERSON ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701274103",
            "telephone_number": "504-289-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 BELLE TERRE BLVD",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700682433",
            "telephone_number": "985-652-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "NGHI",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "7574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Place, LA

Sources for this page

Verify at the official NPI Registry.