Anh T. Pham, DDS, PC

Primary specialty

DentistTaxonomy code 122300000X

License

0401410353 Issued in VA

Legal business name

ANH T. PHAM, DDS, PC

Doing business as

Chantilly Green Dental Care

Practice address

13035 Lee Jackson Memorial Hwy Ste D
Fairfax, VA 22033-2039

Phone

(703) 378-2466

Fax

(703) 378-2467

NPI assigned

Aug 7, 2007

Last updated

Aug 7, 2007By 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. Anh Tu Pham, D.D.S.NPI 1346241957

Title

President

Phone

(703) 378-2466

Specialties & licenses 1

Addresses

Other names 1

• Chantilly Green Dental Care Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anh T Pham, D.D.S.

  • General Practice Dentistry
  • Fairfax, VA
  • NPI 1346241957
  NPD (past) Authorized official
• Richard Usang Koh, DDS, MS

  • Periodontics
  • Los Alamitos, CA
  • NPI 1215135579
  NPD (past)

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1457542144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13035 LEE JACKSON MEMORIAL HWY STE D",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332039",
            "telephone_number": "703-378-2466",
            "fax_number": "703-378-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13035 LEE JACKSON MEMORIAL HWY STE D",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332039",
            "telephone_number": "703-378-2466",
            "fax_number": "703-378-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANH T. PHAM, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "ANH",
        "authorized_official_middle_name": "TU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-378-2466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chantilly Green Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.

Verify at the official NPI Registry.