Minh Ngoc Phan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60102399 Issued in WA

Practice address

4660 Coralwood Cir
Carlsbad, CA 92008-3708

Phone

(303) 469-2061

NPI assigned

Aug 25, 2009

Last updated

Apr 27, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398556800000",
    "number": "1336372242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 CORALWOOD CIR",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920083708",
            "telephone_number": "971-404-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 CORALWOOD CIR",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920083708",
            "telephone_number": "303-469-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "MINH",
        "middle_name": "NGOC",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2014-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN-10341",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61348",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60102399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Thai Pham
• Dorrance Pham, PHARMD
• Michael Trung Pham, DO
• Tram Pham, BCBA
• Kimberly Phan
• Thi Thi Cong Phan, DDS
• Alyssha Phanord
• Pharmaca Integrative Pharmacy, Inc. (Pharmaca Integrative Pharmacy)
• Kathleen Phelps, L.C.S.W.
• Phi and Miyamoto Dental Corporation (La Costa Del Sur Dental Practice)

• General Practice Dentistry in Carlsbad, CA
• Providers in Carlsbad, 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 Apr 27, 2014; 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.