Active NPI
Minh H Phan, DDS
- Dentist
- Pasadena, TX
National Provider Identifier
1417027186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 19016
- Practice address
- 905 E Southmore
Pasadena, TX 77502 - Phone
- (713) 473-7223
- Fax
- (713) 473-7206
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 19016 | TX | Primary |
Addresses
Primary practice location
905 E Southmore
Pasadena, TX 77502
Mailing address
905 E Southmore
Pasadena, TX 77502
Phone (713) 473-7223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19016 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phantastic Dental Care PA | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Galena Park, TX
- NPI 1467118182
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417027186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 E SOUTHMORE",
"city": "PASADENA",
"state": "TX",
"postal_code": "77502",
"telephone_number": "713-473-7223",
"fax_number": "713-473-7206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 E SOUTHMORE",
"city": "PASADENA",
"state": "TX",
"postal_code": "77502",
"telephone_number": "713-473-7223",
"fax_number": "713-473-7206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "MINH",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "19016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.