Active NPI
Celine Pham, D.M.D.
- General Practice Dentistry
- Anaheim, CA
National Provider Identifier
1457507345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 57310
- Practice address
- 1617 S Ivanhoe St
Anaheim, CA 92804-6021 - Phone
- (714) 251-3851
- NPI assigned
- Aug 12, 2008
- 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 | 57310 | CA | Primary |
Addresses
Primary practice location
1617 S Ivanhoe St
Anaheim, CA 92804-6021
Mailing address
1617 S Ivanhoe St
Anaheim, CA 92804-6021
Phone (714) 251-3851
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150606000196 | CA | Order and Referring Only - Dentist | 4981925690 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296604800000",
"number": "1457507345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1617 S IVANHOE ST",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928046021",
"telephone_number": "714-251-3851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1617 S IVANHOE ST",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928046021",
"telephone_number": "714-251-3851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "CELINE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-12",
"last_updated": "2011-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "57310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.