Active NPI
Thanh Hoang Phan, DDS
- Dental Anesthesiology
- Peoria, AZ
National Provider Identifier
1144660358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Anesthesiology
- License
- 8766
- Practice address
- 14100 N 83Rd Ave Ste 280
Peoria, AZ 85381-5660 - Phone
- (714) 467-8672
- NPI assigned
- Jul 2, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Anesthesiology | 1223D0004X | 8766 | AZ | Primary |
| Dental Anesthesiology | 1223D0004X | 62318 | CA |
Addresses
Primary practice location
14100 N 83Rd Ave Ste 280
Peoria, AZ 85381-5660
Mailing address
7950 S Dromedary Dr
Tempe, AZ 85284-1348
Phone (714) 467-8672
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8766 | AZ | MD | Dentist Anesthesiologist |
| 62318 | CA | MD | Dentist Anesthesiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484092800000",
"number": "1144660358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7950 S DROMEDARY DR",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852841348",
"telephone_number": "714-467-8672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14100 N 83RD AVE STE 280",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853815660",
"telephone_number": "714-467-8672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "THANH",
"middle_name": "HOANG",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-02",
"last_updated": "2017-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "AZ",
"license": "8766",
"primary": true
},
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "CA",
"license": "62318",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.