Active NPI
Trang N Pham, DDS
- Periodontics
- Portland, OR
National Provider Identifier
1568534519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- D7173
- Practice address
- 10356 NE Wasco St
Portland, OR 97220 - Phone
- (503) 252-2600
- Fax
- (503) 252-4020
- NPI assigned
- Nov 14, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | D7173 | OR | Primary |
Addresses
Primary practice location
10356 NE Wasco St
Portland, OR 97220
Mailing address
10356 NE Wasco St
Portland, OR 97220
Phone (503) 252-2600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7173 | OR | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568534519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10356 NE WASCO ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97220",
"telephone_number": "503-252-2600",
"fax_number": "503-252-4020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10356 NE WASCO ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97220",
"telephone_number": "503-252-2600",
"fax_number": "503-252-4020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "TRANG",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "OR",
"license": "D7173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.