Phen Dental Professional Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PHEN DENTAL PROFESSIONAL CORPORATION

Practice address

109 Ferrari Ranch Rd Ste 100
Lincoln, CA 95648-7423

Phone

(916) 253-7000

NPI assigned

May 25, 2021

Organization subpart

No

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

Authorized official

Name

Jennifer Phen

Title

Office Manager

Phone

(916) 337-5158

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher Phen, D.D,S

  • General Practice Dentistry
  • Lincoln, CA
  • NPI 1356437008
  NPD

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1457926057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 FERRARI RANCH RD STE 100",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956487423",
            "telephone_number": "916-253-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 FERRARI RANCH RD STE 100",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956487423",
            "telephone_number": "916-253-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHEN DENTAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "PHEN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "916-337-5158"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alister Peters
• Lori Ann Peterson, PT
• Anthony Petraki
• Dara Lyn Pfeiffer
• Benjamin Van Pham, M.D.
• Cameron Phen
• Christopher Phen, D.D,S
• Jordan Phen, DDS
• Mark David Porco, D.D.S.
• Roxanne Dionisio Portugal, OTRL

• Dental Clinic/Center in Lincoln, CA
• Providers in Lincoln, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.