Thi Thi Cong Phan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

49393 Issued in CA

Practice address

2630 El Camino Real
Carlsbad, CA 92008-1214

Phone

(760) 434-1761

NPI assigned

Jun 21, 2017

Sex

Female

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

Practice roles

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.

• Leclair Dental Inc

  • General Practice Dentistry
  • Carlsbad, CA
  • NPI 1558255331
  NPD (past)

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498003200000",
    "number": "1548780604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 LANCASHIRE PL",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920698108",
            "telephone_number": "760-807-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 EL CAMINO REAL",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081214",
            "telephone_number": "760-434-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "THI THI",
        "middle_name": "CONG",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorrance Pham, PHARMD
• Michael Trung Pham, DO
• Tram Pham, BCBA
• Kimberly Phan
• Minh Ngoc Phan, DMD
• Alyssha Phanord
• Pharmaca Integrative Pharmacy, Inc.
• Kathleen Phelps, L.C.S.W.
• Phi and Miyamoto Dental Corporation
• Amber Philbeck, LCSW

• General Practice Dentistry in Carlsbad, CA
• Providers in Carlsbad, 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 Jun 21, 2017; 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.