Individual provider Active NPI

Diana Mai Tram Pham, D.D.S.

  • Dentist
  • Houston, TX
National Provider Identifier
1508279191
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30076 Issued in TX
Practice address
7500 Cambridge St Ste 6310
Houston, TX 77054-2032
Phone
(713) 253-4806
NPI assigned
Jun 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30076 TX Primary

Addresses

Primary practice location

7500 Cambridge St Ste 6310
Houston, TX 77054-2032

Mailing address

7718 Bellaire Blvd
Houston, TX 77036-4934
Phone (713) 253-4806

Other practice location 1

7718 Bellaire Blvd
Houston, TX 77036-4934
Phone (713) 270-7626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 8, 2026 through Apr 8, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30076TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1508279191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7718 BELLAIRE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770364934",
            "telephone_number": "713-253-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 CAMBRIDGE ST STE 6310",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542032",
            "telephone_number": "713-253-4806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7718 Bellaire Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770364934",
            "country_code": "US",
            "telephone_number": "713-270-7626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "DIANA",
        "middle_name": "MAI TRAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "30076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.