Clermont Modern Dentistry, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CLERMONT MODERN DENTISTRY, PA

Practice address

17300 State Road 50
Clermont, FL 34711-8140

Phone

(352) 403-1298

Fax

(352) 415-8365

NPI assigned

Nov 1, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Minh Pham, DDS

Title

Owner Dentist

Phone

(714) 845-8890

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Louise Salalila Carlos, DMD

  • Dentist
  • Belmont, NC
  • NPI 1629754056
  NPD

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635724800000",
    "number": "1548925902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 STATE ROAD 50",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118140",
            "telephone_number": "352-403-1298",
            "fax_number": "352-415-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLERMONT MODERN DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "MINH",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "714-845-8890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clermont Family Eyecare Inc
• Clermont Home Care Inc
• Clermont Internal and Cosmetic Medicine LLC
• Clermont Kids Dentistry PA
• Clermont Medical Center PA
• Clermont Neurologic and Chiropractic,LLC
• Clermont Neurology,PA
• Clermont Oncology Center LLC
• Clermont Pediatric Dentistry, PLLC
• Clermont Pediatrics

• General Practice Dentistry in Clermont, FL
• Providers in Clermont, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.