Tuan Pham, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

057743 Issued in NY

Practice address

224 Haili St
BLDG B
Hilo, HI 96720-2975

Phone

(703) 819-9875

NPI assigned

Jun 17, 2015

Last updated

Jul 22, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

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

State licenses

Interoperability endpoints

• Direct secure messaging: tuan.pham.p1@direct.wcchc.nextgenshare.com

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1336520170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 HAILI ST",
            "address_2": "BLDG B",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202975",
            "telephone_number": "703-819-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 HAILI ST",
            "address_2": "BLDG B",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202975",
            "telephone_number": "703-819-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TUAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Petillo
• Kori Petsch
• William B Pettis, M.S., L.AC, EMAP
• Daniel Victor Dudley Pettit-Lenz
• Lily Pham, RPH
• Phylavanh Phanhtharath, ACNS-BC
• Pharmacy Corporation of America (Pharmerica Hilo)
• Fatima C Phillips, M.D., M.P.H., PH.D.
• Phoenix Center Inc
• Phoenix Center Inc

• Dentist in Hilo, HI
• Providers in Hilo, HI by specialty
• Dentist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; 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.