Thomas Randall Parham, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN0012537 Issued in FL

Practice address

1702 Ridgewood Ave
Holly Hill, FL 32117-5416

Phone

(386) 672-1830

NPI assigned

Apr 24, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205055704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3947 TANO DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321749306",
            "telephone_number": "386-676-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 RIDGEWOOD AVE",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321175416",
            "telephone_number": "386-672-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARHAM",
        "first_name": "THOMAS",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN0012537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Holly Hill, FL
• Providers in Holly Hill, FL by specialty
• Dentist in Florida

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.