Phil Tiet, D.D.S.
Individual provider Active NPI General Practice Dentistry · Wharton, TX
NPI 1477513869 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1477513869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 17052 (TX)
- Practice address
- 1802 N Richmond Rd
Wharton, TX 77488-2715 - Phone
- (979) 532-1920
- Fax
- (979) 532-0630
- NPI assigned
- Mar 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160519001132 | TX | Order and Referring Only - Dentist |
5698064376 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wharton Dental, Inc | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 17052 | TX | Yes |
Addresses
Primary practice location
1802 N Richmond Rd
Wharton, TX 77488-2715
Mailing address
1802 N Richmond Rd
Wharton, TX 77488-2715
Phone (979) 532-1920
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009513501 | Medicaid | TX |
Other names
- Dr. Phuong Tiet
Other providers in Wharton, TX
- Texana Center
- Texas Home Health Skilled Services, LP
- Taryn Leigh Teykl
- Therapy Solutions 4 U, PLLC
- There Is Victory in Jesus Recovery Center
- Lindsey Elizabeth Tijerina
- James Lynn Tiner
- Tony Todd
- Top Comfort & Care
- Alain Luan Ngoc Tran
All providers in Wharton, TX · General Practice Dentistry in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.