Active NPI
Loc Ba Pham, DDS
- General Practice Dentistry
- Los Angeles, CA
National Provider Identifier
1245022334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 111522
- Practice address
- 5971 S Main St Ste 101
Los Angeles, CA 90003-1257 - Phone
- (323) 325-5641
- NPI assigned
- May 22, 2025
- 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 | 111522 | CA | Primary |
Addresses
Primary practice location
5971 S Main St Ste 101
Los Angeles, CA 90003-1257
Mailing address
2329 W Harvard St
Santa Ana, CA 92704-4654
Phone (714) 548-2253
Other practice location 1
4021 S Central Ave
Los Angeles, CA 90011-2707
Phone (323) 325-5641
Other practice location 2
4030 S Western Ave Ste 200
Los Angeles, CA 90062-1634
Phone (323) 410-9221
Other practice location 3
12156 Lakewood Blvd # 2658
Downey, CA 90242-2658
Phone (562) 803-1600
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 |
|---|---|---|---|
| 111522 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765497600000",
"number": "1245022334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2329 W HARVARD ST",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927044654",
"telephone_number": "714-548-2253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5971 S MAIN ST STE 101",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900031257",
"telephone_number": "323-325-5641"
}
],
"practiceLocations": [
{
"address_1": "4021 S Central Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900112707",
"country_code": "US",
"telephone_number": "323-325-5641",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4030 S Western Ave Ste 200",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900621634",
"country_code": "US",
"telephone_number": "323-410-9221",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12156 Lakewood Blvd # 2658",
"address_purpose": "LOCATION",
"city": "Downey",
"state": "CA",
"postal_code": "902422658",
"country_code": "US",
"telephone_number": "562-803-1600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHAM",
"first_name": "LOC",
"middle_name": "BA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-05-22",
"last_updated": "2025-12-12",
"certification_date": "2025-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "111522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.