NPIMap

Organization Active NPI

Minh Pham Dental Corporation

  • General Practice Dentistry
  • La Jolla, CA
National Provider Identifier
1588092969
Registry record updated Oct 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MINH PHAM DENTAL CORPORATION
Practice address
8657 Villa la Jolla Dr
Suite 211
La Jolla, CA 92037-2356
Phone
(858) 272-2260
Fax
(858) 272-2278
NPI assigned
Oct 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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

Authorized official

Name
Minh B Pham
Title
Owner/ DDS
Phone
(858) 272-2260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

8657 Villa la Jolla Dr
Suite 211
La Jolla, CA 92037-2356

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • La Jolla Village Smiles Dentistry and Implants Doing business as

National Provider Directory

National Provider Directory

Locations

8657 Villa La Jolla Dr
Ste 211
La Jolla, CA 92037
Phone (858) 272-2260

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382486400000",
    "number": "1588092969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8657 VILLA LA JOLLA DR",
            "address_2": "SUITE 211",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920372356",
            "telephone_number": "858-272-2260",
            "fax_number": "858-272-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINH PHAM DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-23",
        "last_updated": "2013-10-23",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "MINH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/ DDS",
        "authorized_official_telephone_number": "858-272-2260"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Jolla Village Smiles Dentistry and Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; 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.