Anthony Tuan Pham

Primary specialty

DentistTaxonomy code 122300000X

License

D105543 Issued in CA

Practice address

2658 E Garvey Ave S
West Covina, CA 91791-2113

Phone

(951) 582-1304

NPI assigned

Apr 7, 2022

Last updated

Dec 19, 2023By 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

Locations

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.

• Anthony Pham Dental Corp

  • Dental Clinic/Center
  • West Covina, CA
  • NPI 1760081129
  NPD Authorized official

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1225770605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2658 E GARVEY AVE S",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917912113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2658 E GARVEY AVE S",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917912113",
            "telephone_number": "951-582-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "ANTHONY",
        "middle_name": "TUAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-07",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "D105543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Personal Emergency Response Systems, Inc.
• Juan Pablo Pesqueira Gonzalez, MD
• Peter J Lee DDS Inc (Star Bright Orthodontics)
• Tyler Andrew Peterson, DO
• Sonja Singleton Peverieri, M.A.
• Vivian T Pham, FNP-BC
• Andy Hoang Phan, PHARMD
• Anthony Wong Phan
• Henry Phan
• Pharmedquest Pharmacy Services (Avita Pharmacy 1012)

• Dentist in West Covina, CA
• Providers in West Covina, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.