Joseph Phen, Dentist, a Dental Corporation

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

45172 Issued in CA

Legal business name

JOSEPH PHEN, DENTIST, A DENTAL CORPORATION

Practice address

8351 Elk Grove Blvd Ste 300
Elk Grove, CA 95758-5515

Phone

(916) 691-6997

NPI assigned

Dec 8, 2014

Organization subpart

No

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

Authorized official

Name

Joseph Phen, D.D.S.

Title

Dentist

Phone

(916) 691-6997

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1164820130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8351 ELK GROVE BLVD STE 300",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957585515",
            "telephone_number": "916-691-6997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8351 ELK GROVE BLVD STE 300",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957585515",
            "telephone_number": "916-691-6997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH PHEN, DENTIST, A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "PHEN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "916-691-6997",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "45172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTISTRY",
            "identifier": "1285691907",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronnie Jones
• Asher David Jordan, M.A., ED.D.
• Patrick James Jordan
• Tamara Jordan
• Jose a. Acosta-Cuevas, DDS, Inc.
• Joseph Rawlins Dental Corporation
• John Joseph
• Stephen Jotten
• Francis Madarang Joven, D.M.D.
• Jeremy Joves

• Preferred Provider Organization in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; 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.