NPIMap

Organization Active NPI

Jennifer M. Pham DMD PC

Doing business as Downtown Family Dental of Leesburg

  • General Practice Dentistry
  • Leesburg, VA
National Provider Identifier
1376190744
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JENNIFER M. PHAM DMD PC
Doing business as
Downtown Family Dental of Leesburg
Practice address
18 Wirt St SW
Leesburg, VA 20175-2915
Phone
(703) 777-5600
NPI assigned
Aug 21, 2019
Last updated
Aug 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Authorized official

Name
Dr. Jennifer Minh Pham, DMDNPI 1801193982
Title
President
Phone
(703) 629-5088

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

18 Wirt St SW
Leesburg, VA 20175-2915

Mailing address

42550 Stires Dr
Chantilly, VA 20152-6655
Phone (703) 629-5088

Other names 1

  • DOWNTOWN FAMILY DENTAL OF LEESBURG Doing business as

National Provider Directory

National Provider Directory

Locations

18 Wirt St SW
Leesburg, VA 20175
Phone (703) 777-5600

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1376190744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42550 STIRES DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201526655",
            "telephone_number": "703-629-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 WIRT ST SW",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201752915",
            "telephone_number": "703-777-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER M. PHAM DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-21",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MINH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-629-5088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOWNTOWN FAMILY DENTAL OF LEESBURG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.