Roger Van Pham, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

100597 Issued in CA

Practice address

5603 Auburn St Unit B
Bakersfield, CA 93306-2979

Phone

(661) 327-2189

Fax

(661) 327-4350

NPI assigned

Jan 28, 2016

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Roger V Pham, D.D.S., Inc.

  dba Gentle Family Dentistry

  • Dental Clinic/Center
  • Bakersfield, CA
  • NPI 1538983267
  NPD Authorized official
• Roger V. Pham, D.D.S., a Professional Dental Corporation

  dba Auburn Dental Center

  • Dental Clinic/Center
  • Bakersfield, CA
  • NPI 1851115596
  NPD Authorized official
• Huynh and Watanabe Dental Corporation

  dba River Lakes Dental Group

  • General Practice Dentistry
  • Bakersfield, CA
  • NPI 1225137573
  NPD (past)

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731196800000",
    "number": "1295193746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11510 HELIOTROPE CT",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933118749",
            "telephone_number": "714-603-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5603 AUBURN ST UNIT B",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933062979",
            "telephone_number": "661-327-2189",
            "fax_number": "661-327-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "ROGER",
        "middle_name": "VAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-28",
        "last_updated": "2024-11-10",
        "certification_date": "2024-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jovianne Pham, PT, DPT
• Kieuanh Thi Pham, MD
• Nina Pham, OD
• Randy Pham
• Rhoda Diem-Hong Pham, D.O.
• Tho Pham, M.D.
• Ashli Phan
• Jason Chanhtrung Phan
• Joe Phan, PHARMD
• Khanh C Phan, PHARMD

• General Practice Dentistry in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2024; 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.

Verify at the official NPI Registry.