NPIMap

Organization Active NPI

Derick Pham DMD, Inc

  • General Practice Dentistry
  • Los Alamitos, CA
National Provider Identifier
1245828219
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DERICK PHAM DMD, INC
Practice address
3612 Florista St
Los Alamitos, CA 90720-2423
Phone
(562) 598-4207
NPI assigned
Jan 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Authorized official

Name
Dr. Derick Pham, DMDNPI 1093247074
Title
Owner Dentist
Phone
(631) 693-9040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3612 Florista St
Los Alamitos, CA 90720-2423

Mailing address

3612 Florista St
Los Alamitos, CA 90720-2423
Phone (562) 598-4207

Other names 1

  • OC Dental Spa Doing business as

National Provider Directory

National Provider Directory

Locations

3612 Florista St
Los Alamitos, CA 90720
Phone (562) 598-4207

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609891200000",
    "number": "1245828219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 FLORISTA ST",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202423",
            "telephone_number": "562-598-4207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 FLORISTA ST",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202423",
            "telephone_number": "562-598-4207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERICK PHAM DMD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "DERICK",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "631-693-9040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OC Dental Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.