Active NPI
Minh Phan, DMD
- General Practice Dentistry
- Spring, TX
National Provider Identifier
1265803050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 31462
- Practice address
- 31406 Weston Village Dr
Spring, TX 77386-2596 - Phone
- (832) 659-2564
- NPI assigned
- Oct 19, 2015
- 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 | 31462 | TX | Primary |
Addresses
Primary practice location
31406 Weston Village Dr
Spring, TX 77386-2596
Mailing address
31406 Weston Village Dr
Spring, TX 77386-2596
Phone (832) 659-2564
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170403001981 | TX | Order and Referring Only - Dentist | 8224314315 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31462 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445212800000",
"number": "1265803050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31406 WESTON VILLAGE DR",
"city": "SPRING",
"state": "TX",
"postal_code": "773862596",
"telephone_number": "832-659-2564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31406 WESTON VILLAGE DR",
"city": "SPRING",
"state": "TX",
"postal_code": "773862596",
"telephone_number": "832-659-2564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "MINH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-10-19",
"last_updated": "2015-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "31462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.