NPIMap

Organization Active NPI

Mary R. Pham, D.D.S., Inc.

Doing business as Lollipop Pediatric Dentistry

  • Pediatric Dentistry
  • Costa Mesa, CA
National Provider Identifier
1164986220
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
MARY R. PHAM, D.D.S., INC.
Doing business as
Lollipop Pediatric Dentistry
Practice address
2750 Harbor Blvd # B-06
Costa Mesa, CA 92626-5121
Phone
(334) 657-7668
NPI assigned
Jan 23, 2019
Last updated
Jan 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Authorized official

Name
Dr. Paul Pham, PHARMD.NPI 1215274188
Title
Manager
Phone
(334) 657-7668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU

Addresses

Primary practice location

2750 Harbor Blvd # B-06
Costa Mesa, CA 92626-5121

Mailing address

2750 Harbor Blvd # B-06
Costa Mesa, CA 92626-5121
Phone (334) 657-7668

Other names 1

  • Lollipop Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1164986220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 HARBOR BLVD # B-06",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265121",
            "telephone_number": "334-657-7668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 HARBOR BLVD # B-06",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265121",
            "telephone_number": "334-657-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY R. PHAM, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "334-657-7668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lollipop Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.