NPIMap

Organization Active NPI

Boynton Beach Modern Dentistry, PA

  • Dentist
  • Boynton Beach, FL
National Provider Identifier
1194288985
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BOYNTON BEACH MODERN DENTISTRY, PA
Practice address
7375 Boynton Beach Blvd, BLDG D
Suite 445
Boynton Beach, FL 33437
Phone
(561) 200-2904
NPI assigned
Apr 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Authorized official

Name
Dr. Minh Pham, DDS
Title
Owner/DDS
Phone
(561) 200-2904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

7375 Boynton Beach Blvd, BLDG D
Suite 445
Boynton Beach, FL 33437

Mailing address

PO Box 920050
Dallas, TX 75392-0050

Other names 1

  • Boynton Beach Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

7375 Boynton Beach Blvd
Ste 445
Boynton Beach, FL 33437
Phone (561) 200-2904

8773 Boynton Beach Blvd
Unit 520
Boynton Beach, FL 33472
Phone (561) 200-2904

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1194288985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7375 BOYNTON BEACH BLVD, BLDG D",
            "address_2": "SUITE 445",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33437",
            "telephone_number": "561-200-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYNTON BEACH MODERN DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-09",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "MINH",
        "authorized_official_title_or_position": "OWNER/DDS",
        "authorized_official_telephone_number": "561-200-2904",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boynton Beach Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Boynton Beach Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.