Duy-Phu Phan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS101456 Issued in CA

Practice address

4555 Hopyard Rd Ste C-19
Pleasanton, CA 94588

Phone

(917) 932-3217

NPI assigned

Jun 4, 2015

Sex

Male

Sole proprietor

Yes

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 NY

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

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144600123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 ST PATRICK WAY APT 558",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945684887",
            "telephone_number": "917-932-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 HOPYARD RD STE C-19",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "94588",
            "telephone_number": "917-932-3217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 Elkhorn Ct Unit 321",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944032620",
            "country_code": "US",
            "telephone_number": "917-932-3217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "DUY-PHU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS101456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haleh Pezeshkan, M.S. CCC-SLP
• Apoorva Phadke, PT DPT
• Jenny Pham
• Lilian Pham, PA-C
• Tuyen Pham
• Lauren Thuy-Vy Phan, D.D.S.
• Michelle V. Phillips, D.D.S
• William H Phillips, M.D.
• Kevin Phu
• Hoan T Phung

• General Practice Dentistry in Pleasanton, CA
• Providers in Pleasanton, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.