Hung Quoc Pham

Primary specialty

DentistTaxonomy code 122300000X

License

11263872-9922 Issued in UT

Practice address

50 N Medical Dr
Salt Lake City, UT 84132-0001

Phone

(385) 202-9721

NPI assigned

Apr 13, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1508353731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2263 W AUGUST FARMS CIR",
            "city": "WEST VALLEY",
            "state": "UT",
            "postal_code": "841196044",
            "telephone_number": "385-202-9721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "385-202-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "HUNG",
        "middle_name": "QUOC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-13",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "11263872-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Alan Pfitzner, MD MPH
• Courtney Pflieger, PH.D.
• Tshegofatso Pearl Phalwane Clark
• Duy Pham, M.D.
• Hoang Nhat Pham, MD
• Kendra Elizabeth Pham, MD, MPH
• Laura Diem Pham
• Lauren T. Pham, DO
• Nancy Pham, NP
• Nikki Pham, M.D.

• Dentist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.