Patricia Hiep-Chan T. Phan-Underhill, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

48845 Issued in CA

Practice address

14543 S Bascom Ave
Los Gatos, CA 95032-2003

Phone

(408) 358-5115

NPI assigned

Oct 11, 2007

Last updated

Nov 10, 2009By 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 1

Addresses

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.

Opted out of Medicare

Yes, effective Mar 9, 2016 through Mar 9, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shirin Shahinfar Imani DDS Inc

  dba Foster City Dental Care

  • General Practice Dentistry
  • San Mateo, CA
  • NPI 1154329084
  NPD (past)

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1346438645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14543 S. BASCOM AVENUE",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950328000",
            "telephone_number": "408-358-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14543 S BASCOM AVE",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322003",
            "telephone_number": "408-358-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN-UNDERHILL",
        "first_name": "PATRICIA HIEP-CHAN",
        "middle_name": "T.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominic Petrino
• Sarah Peyton-Guardado, FNP
• Derek Pham
• Kathy Khanh Pham, PHARMD
• Nha Thanh Pham, D.P.M
• Alvin Phavan Phan
• Brandon Phan, PMHNP
• Kathleen P Phan, DMD
• Khanh Phan
• Pharmaca Integrative Pharmacy, Inc.

• Dentist in Los Gatos, CA
• Providers in Los Gatos, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.