109 Dental Group, Professional Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

109 DENTAL GROUP, PROFESSIONAL CORPORATION

Doing business as

109 Dental Group

Practice address

10900 Warner Ave Ste 109
Fountain Valley, CA 92708-3846

Phone

(714) 963-5634

NPI assigned

Oct 17, 2026

Last updated

Oct 17, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Thomas M Pham, DMD

Title

Owner Dentist

Phone

(805) 484-3599

Specialties & licenses 1

Addresses

Other names 1

• 109 Dental Group Doing business as

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

{
    "created_epoch": "1792195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792195200000",
    "number": "1447156245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MOBIL AVE STE A4",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106375",
            "telephone_number": "805-484-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 WARNER AVE STE 109",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083846",
            "telephone_number": "714-963-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "109 DENTAL GROUP, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-17",
        "last_updated": "2026-10-17",
        "certification_date": "2026-10-17",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "805-484-3599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "109 Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 365 Acupuncture Inc.
• 3TTT a Professional Corporation
• 95Western Youth Services
• A. Ko, M.D., Inc. (Bristol Pediatrics Inc.)
• A.S. Sawhney, M.D., Inc.

• General Practice Dentistry in Fountain Valley, CA
• Providers in Fountain Valley, 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 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.