Dung Q Pham, DN

Primary specialty

DenturistTaxonomy code 122400000X

License

DN00000360 Issued in WA

Practice address

315 E Casino Rd
Suite B
Everett, WA 98208-1846

Phone

(425) 355-4409

NPI assigned

Feb 22, 2007

Last updated

Apr 26, 2013By the provider in NPPES

Sex

Male

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Smile Bright Denture Center Ballard Inc.

  • Denturist
  • Seattle, WA
  • NPI 1447657382
  NPD (past) Authorized official
• Smile Bright Denture Center LLC

  • Denturist
  • Everett, WA
  • NPI 1912085390
  NPD (past) Authorized official

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1194850073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E CASINO RD",
            "address_2": "SUITE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982081846",
            "telephone_number": "425-355-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E CASINO RD",
            "address_2": "SUITE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982081846",
            "telephone_number": "425-355-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "DUNG",
        "middle_name": "Q",
        "name_prefix": "Mr.",
        "credential": "DN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "WA",
            "license": "DN00000360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Petrova, FNP
• Malaysia Pettis
• Kayla Geo Petz
• Monica Allene Pfaff, RD,CD
• Megan Pfohl, OTR/L
• Jonathan Phong Pham
• Kim K Pham, RPH
• Mo Thi Pham, OTR/L
• Nicole Pham, RPH
• Andrew Phan, MD

• Denturist in Everett, WA
• Providers in Everett, WA by specialty
• Denturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2013; 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.