Michael Pham, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

64987 Issued in CA

Practice address

2801 Waterman Blvd Ste 290
Fairfield, CA 94534-2972

Phone

(707) 425-5666

NPI assigned

Aug 31, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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 and National Provider Directory roles.

• Michael Pham, DDS, Ms, Inc

  • Endodontics
  • Fairfield, CA
  • NPI 1427702836
  NPD Authorized official

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1245607837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 WATERMAN BLVD STE 290",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945342972",
            "telephone_number": "707-425-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 WATERMAN BLVD STE 290",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945342972",
            "telephone_number": "707-425-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-31",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "64987",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14185",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Anne Petrilla, PHARMD, CDE
• Yolanta Petrofsky, MD
• Jennifer Petruzzi
• Jennifer Ruth Pettibone, RN
• Michael John Pfisterer, M.D.
• Thuytien Pham, DO
• Sang Ngoc Phan
• Pharmatox, Inc
• Pharmatox, Inc.
• Flashanya Phenix

• Endodontics in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.