Active NPI
Phung K Pham DDS Inc
- General Practice Dentistry
- Fresno, CA
National Provider Identifier
1356499560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 52453
- Legal business name
- PHUNG K PHAM DDS INC
- Practice address
- 1727 N Fresno St
Fresno, CA 93703-3031 - Phone
- (559) 227-5239
- Fax
- (559) 227-9262
- NPI assigned
- Jan 7, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Phung Kim Pham
- Title
- Ceo
- Phone
- (559) 227-5239
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 52453 | CA | Primary |
Addresses
Primary practice location
1727 N Fresno St
Fresno, CA 93703-3031
Mailing address
1727 N Fresno St
Fresno, CA 93703-3031
Phone (559) 227-5239
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D52453 | Other | CA | RENDERING PROVIDER NUMBER |
| G94117-01 | Other | CA | BILLING PROVIDER NUMBER |
National Provider Directory
National Provider DirectoryLocations
1727 N Fresno St
Fresno, CA 93703
Phone (559) 227-5239
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Fresno, CA
- NPI 1487870457
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168128000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1493337600000",
"number": "1356499560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1727 N FRESNO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937033031",
"telephone_number": "559-227-5239",
"fax_number": "559-227-9262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1727 N FRESNO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937033031",
"telephone_number": "559-227-5239",
"fax_number": "559-227-9262"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHUNG K PHAM DDS INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-07",
"last_updated": "2017-04-28",
"status": "A",
"authorized_official_last_name": "PHAM",
"authorized_official_first_name": "PHUNG",
"authorized_official_middle_name": "KIM",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "559-227-5239"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "52453",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RENDERING PROVIDER NUMBER",
"identifier": "D52453",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BILLING PROVIDER NUMBER",
"identifier": "G94117-01",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.