Gary Benjamin Phillips, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20715 Issued in CA

Practice address

4255 Campus Dr # 260
Irvine, CA 92612-2620

Phone

(949) 856-0411

NPI assigned

May 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497964928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22182 SHADE TREE LN",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303319",
            "telephone_number": "949-770-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 CAMPUS DR # 260",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122620",
            "telephone_number": "949-856-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "GARY",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "20715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Chiou MD Inc
• Philip D. Jo, D.D.S. Inc.
• Drew A Philip, DNP, APRN, FNP-C
• Sogol Philipson, LCSW
• Ava Desiree Phillips
• Joseph James Phillips
• Kenneth Phillips
• Lagina Phillips
• Philong Pham DDS Dental Professional Corporation
• Kaitlyn Elizabeth Philpott, PA-C

• General Practice Dentistry in Irvine, CA
• Providers in Irvine, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.