Thien-Kim Thi Pham, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

29134 Issued in TX

Practice address

2508 Gulf Fwy S Ste 108
League City, TX 77573-6743

Phone

(281) 678-8344

Fax

(866) 245-0553

NPI assigned

Jun 28, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kim Pham Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Autumn Family Dentistry, P.L.L.C.

  • Dental Clinic/Center
  • League City, TX
  • NPI 1568813186

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1508206079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 GULF FWY S",
            "address_2": "STE 108",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775736743",
            "telephone_number": "281-678-8344",
            "fax_number": "866-245-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 GULF FWY S STE 108",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775736743",
            "telephone_number": "281-678-8344",
            "fax_number": "866-245-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "THIEN-KIM",
        "middle_name": "THI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "PHAM",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Roman V Petrov, MD
• PF Development 7, LLC
• PF Development 7, LLC
• Jimmy Vinh Pham
• Julie HT Pham
• Trung Thu Pham, PHARM.D.
• Uyen Pham
• Myphuong Theresa Phan, MD
• Tam Thi Thanh Phan
• Pharaoh Health and Rehab, PLLC

• General Practice Dentistry in League City, TX
• Providers in League City, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.