Individual provider Active NPI

Uyen T Phan, RDH

  • Dental Hygienist
  • Mesquite, TX
National Provider Identifier
1215164652
Registry record updated Jun 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
14848 Issued in TX
Practice address
1927 Faithon P Lucas Sr Blvd # Sr
Suite120
Mesquite, TX 75181-1696
Phone
(469) 341-3888
NPI assigned
Jun 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 14848 TX Primary

Addresses

Primary practice location

1927 Faithon P Lucas Sr Blvd # Sr
Suite120
Mesquite, TX 75181-1696

Mailing address

1927 Faithon P Lucas Sr Blvd # Sr
Suite120
Mesquite, TX 75181-1696
Phone (469) 341-3888

Other identifiers 1

IdentifierTypeStateIssuer
14848OtherTXDENTAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14848TXMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Network Provider Associates, P.C. Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244678400000",
    "number": "1215164652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1927 FAITHON P LUCAS SR BLVD # SR",
            "address_2": "SUITE120",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751811696",
            "telephone_number": "469-341-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1927 FAITHON P LUCAS SR BLVD # SR",
            "address_2": "SUITE120",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751811696",
            "telephone_number": "469-341-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "UYEN",
        "middle_name": "T",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-11",
        "last_updated": "2009-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "TX",
            "license": "14848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "14848",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; 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.