Lily Pham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105422 Issued in CA

Practice address

27412 Antonio Pkwy Ste R4
Ladera Ranch, CA 92694-2164

Phone

(949) 347-7083

NPI assigned

Nov 27, 2020

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vanson Dental Corporation

  • Dentist
  • Tustin, CA
  • NPI 1487175410
  NPD (past)

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

{
    "created_epoch": "1606435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1164026415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31281 VIA PARRA",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752847",
            "telephone_number": "714-383-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27412 ANTONIO PKWY STE R4",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942164",
            "telephone_number": "949-347-7083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "LILY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-27",
        "last_updated": "2022-01-04",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lincoln Charles Parker, D.M.D
• Renee Parr, RDH BS MFT
• Aubrey Lynn Patterson
• Ying Peng, MD, PHD
• Izaac Alexander Perez
• Florencia Pina, NTP
• Eunice Pioche, OTR/L
• Shawn Philip Plowman, PA-C MMS
• Stephanie Kay Plowman, DPT, PA-C
• Robert Potts

• General Practice Dentistry in Ladera Ranch, CA
• Providers in Ladera Ranch, 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 Jan 4, 2022; 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.