Hayden Pham, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

104658 Issued in CA

Practice address

21029 Devonshire St
Chatsworth, CA 91311-2315

Phone

(818) 998-6446

Fax

(818) 998-5005

NPI assigned

Jul 25, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Pham & Jan Dental Corporation

  • Dental Clinic/Center
  • Chatsworth, CA
  • NPI 1952078677
  NPD Authorized official
• Chatsworth Family Dental Group

  • Dental Clinic/Center
  • Chatsworth, CA
  • NPI 1003109612
  NPD (past)
• Familia Dental West Green Bay

  • Dental Clinic/Center
  • Green Bay, WI
  • NPI 1588197149
  NPD (past)

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1306490719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21029 DEVONSHIRE ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112315",
            "telephone_number": "818-998-6446",
            "fax_number": "818-998-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21029 DEVONSHIRE ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112315",
            "telephone_number": "818-998-6446",
            "fax_number": "818-998-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "HAYDEN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-25",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "104658",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1002168",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zuleima Perez
• Persian-American Adult Day Health Care Center, Inc.
• Syuzanna Petrosyan, LVN
• Petrus Corp.
• Pham & Jan Dental Corporation
• Pharmacist Holding Group
• Pharmacist Integrative Healthcare, Inc.
• Megan Anna Philip
• Phillips Graduate University
• Phillip Nguyen Phung, FNP

• Dentist in Chatsworth, CA
• Providers in Chatsworth, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.