Mary Pham Ikeda Dental Corporation

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MARY PHAM IKEDA DENTAL CORPORATION

Doing business as

Lollipop Pediatric Dentistry & Orthodontics

Practice address

13047 Artesia Blvd Ste C100
Cerritos, CA 90703-1369

Phone

(714) 528-8252

NPI assigned

Dec 22, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Mary Regina Pham, DDS MSNPI 1316188030

Title

Ceo Pediatric Dentist

Phone

(714) 528-8252

Specialties & licenses 2

Addresses

Other names 1

• Lollipop Pediatric Dentistry & Orthodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Regina Pham, D.D.S., M.S.

  • Pediatric Dentistry
  • Placentia, CA
  • NPI 1316188030
  NPD (past) Authorized official

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1518554641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 HARBOR BLVD STE B6",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265121",
            "telephone_number": "714-528-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13047 ARTESIA BLVD STE C100",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031369",
            "telephone_number": "714-528-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY PHAM IKEDA DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "REGINA",
        "authorized_official_title_or_position": "CEO PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "714-528-8252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lollipop Pediatric Dentistry & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karla Martinez
• Lauren Martinez
• Leslie Celina Martinez, B.A
• Liliana Martinez
• Teeda M Martoccia, CRNA
• Christopher Komaki Masigla
• Masler Chiropractic
• Masler Chiropractic Inc
• Todd S Masler, D.C.
• Oliver Lee Mason, MD

• Pediatric Dentistry in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.