Individual provider Active NPI

Kevin Minh-Huy Pham, DMD

  • General Practice Dentistry
  • Wichita, KS
National Provider Identifier
1306456702
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61998 Issued in KS
Practice address
2707 E 21St St N
Wichita, KS 67214-2249
Phone
(316) 691-0249
Fax
(877) 803-1562
NPI assigned
Jul 31, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61998 KS Primary
General Practice Dentistry 1223G0001X 36470 TX

Addresses

Primary practice location

2707 E 21St St N
Wichita, KS 67214-2249

Mailing address

2707 E 21St St N
Wichita, KS 67214-2249
Phone (316) 691-0249

Other practice location 1

2700 E 30th Ave
Hutchinson, KS 67502-1242
Phone (620) 663-8484

Other practice location 2

344 NW Loop 564 Ste 400
Mineola, TX 75773-1128
Phone (903) 638-8287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61998KSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Prairiestar Health Center, Inc Past Accepting new patients

Organizations & group practices 1

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": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1306456702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142249",
            "telephone_number": "316-691-0249",
            "fax_number": "877-803-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142249",
            "telephone_number": "316-691-0249",
            "fax_number": "877-803-1562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 E 30th Ave",
            "address_purpose": "LOCATION",
            "city": "Hutchinson",
            "state": "KS",
            "postal_code": "675021242",
            "country_code": "US",
            "telephone_number": "620-663-8484",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "344 NW Loop 564 Ste 400",
            "address_purpose": "LOCATION",
            "city": "Mineola",
            "state": "TX",
            "postal_code": "757731128",
            "country_code": "US",
            "telephone_number": "903-638-8287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KEVIN",
        "middle_name": "MINH-HUY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-31",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61998",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "36470",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.