Lan Thanh Pham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12144 Issued in GA

Practice address

5775 Jimmy Carter Blvd
Good Care Dental Ste 440
Norcross, GA 30071

Phone

(770) 447-4702

Fax

(770) 447-4705

NPI assigned

Sep 1, 2006

Last updated

Jul 8, 2007By 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.

• Good Care Dental LLC

  • Dental Clinic/Center
  • Norcross, GA
  • NPI 1366606741
  NPD (past) Authorized official

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235231481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 BRANDIE ELAINE AVE",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "30078",
            "telephone_number": "770-736-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 JIMMY CARTER BLVD",
            "address_2": "GOOD CARE DENTAL STE 440",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "30071",
            "telephone_number": "770-447-4702",
            "fax_number": "770-447-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "LAN",
        "middle_name": "THANH",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "12144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig K. Petek, DC
• Harrison Peters
• Brian Pham
• Brian Dinh Pham, RPH
• Christine Phuong Bach Pham, D.D.S.
• Maitram Thi Pham, BS.
• Ngan Mai Pham, M.D.
• Nghia Pham, D.C.
• Thao Hieu Pham, PA-C
• Truc Thanh Pham, M.D.

• General Practice Dentistry in Norcross, GA
• Providers in Norcross, GA by specialty
• General Practice Dentistry in Georgia

• 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.