Camtu Pham, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53097 Issued in CA

Practice address

30212 Tomas
Suite 340
Rancho Santa Margarita, CA 92688

Phone

(949) 888-5665

Fax

(949) 888-6835

NPI assigned

Jul 17, 2006

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 6, 2015 through Nov 6, 2027

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Jordan Pham Dental Corporation

  dba Jordan & Pham Dentistry

  • Point of Service
  • Rancho Santa Margarita, CA
  • NPI 1710205505
  NPD

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1457379745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30212 TOMAS",
            "address_2": "SUITE 340",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "92688",
            "telephone_number": "949-888-5665",
            "fax_number": "949-888-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30212 TOMAS",
            "address_2": "SUITE 340",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "92688",
            "telephone_number": "949-888-5665",
            "fax_number": "949-888-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "CAMTU",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Pearson, RDN
• Devallee Pedrogo, PTA
• Penrod Dental Care, Inc.
• Periodontics, Oral and Facial Surgical Specialties (Orange County Oral Surgery and Periodontics)
• Jenyffer Peterson
• Lillian Man Phan, DPT
• Physician Assistant Specialists-California Inc
• Pierson Family Chiropractic
• Michael Todd Pierson, D.C.
• Shannon Pink, DPT

• General Practice Dentistry in Rancho Santa Margarita, CA
• Providers in Rancho Santa Margarita, 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 May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.