Grant and Pham Dental Corporation

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

51412 Issued in CA

Legal business name

GRANT AND PHAM DENTAL CORPORATION

Practice address

9710 Winter Gardens Blvd
Lakeside, CA 92040-3866

Phone

(619) 443-8447

NPI assigned

Jun 22, 2009

Organization subpart

No

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

Authorized official

Name

Richard Grant

Title

Owner

Phone

(858) 205-3872

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247443200000",
    "number": "1457588055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9710 WINTER GARDENS BLVD",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920403866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9710 WINTER GARDENS BLVD",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920403866",
            "telephone_number": "619-443-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT AND PHAM DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-22",
        "last_updated": "2009-07-13",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-205-3872"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "52916",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "51412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Torres Gonzalez
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• Michael James Gorence, PHARMD
• Don Richard Graham, D.D.S.
• Ray Gros
• Raewyn Guerrero
• John-Paul M Guillot, DPM
• Joshua Gunpat
• Habilitative Homes Residential Care Facility

• Orthodontics and Dentofacial Orthopedics Dentistry in Lakeside, CA
• Providers in Lakeside, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; 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.