Active NPI
Alexandra Pham, DDS
- General Practice Dentistry
- El Paso, TX
National Provider Identifier
1417529546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 37511
- Practice address
- 1050 Sunland Park Dr # B200
El Paso, TX 79922-1326 - Phone
- (915) 213-1200
- NPI assigned
- Jul 16, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 37511 | TX | Primary |
Addresses
Primary practice location
1050 Sunland Park Dr # B200
El Paso, TX 79922-1326
Mailing address
1050 Sunland Park Dr # B200
El Paso, TX 79922-1326
Phone (915) 213-1200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 28, 2022 through Nov 28, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37511 | TX | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669593600000",
"number": "1417529546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 SUNLAND PARK DR # B200",
"city": "EL PASO",
"state": "TX",
"postal_code": "799221326",
"telephone_number": "915-213-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 SUNLAND PARK DR # B200",
"city": "EL PASO",
"state": "TX",
"postal_code": "799221326",
"telephone_number": "915-213-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "ALEXANDRA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-16",
"last_updated": "2022-11-28",
"certification_date": "2022-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "37511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.