NPIMap

Individual provider Active NPI

Vinh Dam, PHARM.D.

  • Pharmacist
  • Bloomfield, NJ
National Provider Identifier
1255640355
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RS00570900 Issued in NJ
Practice address
77-105 Bloomfield Ave
Bloomfield, NJ 07003-5985
Phone
(973) 259-9290
NPI assigned
Oct 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RS00570900 NJ Primary

Addresses

Primary practice location

77-105 Bloomfield Ave
Bloomfield, NJ 07003-5985

Mailing address

78 Ferry St
Floor 2 Apt #1
Newark, NJ 07105
Phone (949) 705-8386

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
28RS00570900NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mixlab TX, LLC Current Accepting new patients
Mixlab Wi, LLC Current Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1255640355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 FERRY ST",
            "address_2": "FLOOR 2 APT #1",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07105",
            "telephone_number": "949-705-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77-105 BLOOMFIELD AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070035985",
            "telephone_number": "973-259-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAM",
        "first_name": "VINH",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-07",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RS00570900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; 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.