Active NPI
Paul Phan, DDS
- General Practice Dentistry
- Anthem, AZ
National Provider Identifier
1235385972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D7637
- Practice address
- 42407 N Vision Way
101
Anthem, AZ 85086-1480 - Phone
- (623) 551-7500
- Fax
- (623) 551-2400
- NPI assigned
- Aug 13, 2008
- Last updated
- Aug 13, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D7637 | AZ | Primary |
Addresses
Primary practice location
42407 N Vision Way
101
Anthem, AZ 85086-1480
Mailing address
42407 N Vision Way
101
Anthem, AZ 85086-1480
Phone (623) 551-7500
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
| License | State | Type | Specialty |
|---|---|---|---|
| D7637 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crown Dental | General Practice | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218585600000",
"number": "1235385972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42407 N VISION WAY",
"address_2": "101",
"city": "ANTHEM",
"state": "AZ",
"postal_code": "850861480",
"telephone_number": "623-551-7500",
"fax_number": "623-551-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42407 N VISION WAY",
"address_2": "101",
"city": "ANTHEM",
"state": "AZ",
"postal_code": "850861480",
"telephone_number": "623-551-7500",
"fax_number": "623-551-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "PAUL",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-13",
"last_updated": "2008-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D7637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anthem, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.