Kimberly Nguyen Pham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53642 Issued in CA

Practice address

2379 N. Oxnard Blvd
Oxnard, CA 93030

Phone

(805) 278-9499

NPI assigned

May 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in CA

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

Practice roles

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

• Donny Emanuel DMD a Prof Dental Corp

  • Dentist
  • Oxnard, CA
  • NPI 1215074570
  NPD (past)

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174735062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 SOMBRA WAY",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "93030",
            "telephone_number": "805-604-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2379 N. OXNARD BLVD",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "93030",
            "telephone_number": "805-278-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KIMBERLY",
        "middle_name": "NGUYEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evalis Peters
• Douglas Alvin Peterson, PHD
• Janelle Maria Petris
• Shannon Pflaumer
• Jennifer Pham, DDS
• Thomas M Pham, DMD
• Kevin Tai Phan
• Thanh T Phan
• Samuel K. Phang, MD
• Pharmacy & Health Management Services, Inc. (Farmacia Estrella)

• General Practice Dentistry in Oxnard, CA
• Providers in Oxnard, 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 8, 2007; 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.