Quynh Vo Bao Pham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS102880 Issued in CA

Practice address

3767 Avocado Blvd
La Mesa, CA 91941-7301

Phone

(619) 729-2323

NPI assigned

Oct 5, 2018

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: qpham18352@syhealth.direct-ci.com

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.

• Cheryl Tran DDS Inc.

  • General Practice Dentistry
  • La Mesa, CA
  • NPI 1396128658
  NPD (past)

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1366917353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10812 PACIFIC CANYON WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214337",
            "telephone_number": "310-720-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3767 AVOCADO BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919417301",
            "telephone_number": "619-729-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "QUYNH",
        "middle_name": "VO BAO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-05",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS102880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devid Petrus, PHARMD
• Nicole Marie Petruso, OTR
• Bao Pham, PHARM.D.
• Cindy Dang Pham, MPT
• Matt T Pham, O.D.
• Thuy-Linh Pham
• Thanhtruc Hoang Phan, FNP-C
• Philip D Szold MD Inc
• Phillip Dickinson, M.D., a Professional Corporation
• Jarrad Marshall Phillips, ATC

• General Practice Dentistry in La Mesa, CA
• Providers in La Mesa, 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 Oct 5, 2018; 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.