Bryan Quang Phamnguyen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13272 Issued in FL

Practice address

1417 N Semoran Blvd
Ste 104
Orlando, FL 32807-3555

Phone

(407) 381-1200

Fax

(407) 381-9970

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mr. Quang Nguyen Pham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275752636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5908 TAMANACO TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328173279",
            "telephone_number": "407-493-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 N SEMORAN BLVD",
            "address_2": "STE 104",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328073555",
            "telephone_number": "407-381-1200",
            "fax_number": "407-381-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAMNGUYEN",
        "first_name": "BRYAN",
        "middle_name": "QUANG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "13272",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16792",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39869",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "QUANG",
            "last_name": "PHAM",
            "middle_name": "NGUYEN",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tom Pham
• Trinh Pham
• VI Xuan Pham
• Vihieu Pham, DO
• Vinh Quang Pham, RPH
• Kim Thoa Phan-Dinh, DDS
• Cuong Tien Phan
• Hai Phan
• Ivy Kim Long Phan, APRN
• June Phan, RPH

• General Practice Dentistry in Orlando, FL
• Providers in Orlando, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.