NPIMap

Organization Active NPI

Diep Pham PC

  • Dental Clinic/Center
  • Vancouver, WA
National Provider Identifier
1598247884
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D9395 Issued in OR
Legal business name
DIEP PHAM PC
Practice address
13510 NE 84TH St Ste 105
Vancouver, WA 98682
Phone
(360) 726-6966
NPI assigned
Sep 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Authorized official

Name
Diep PhamNPI 1790007565
Title
General Dentist
Phone
(503) 888-6077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D9395 OR Primary

Addresses

Primary practice location

13510 NE 84TH St Ste 105
Vancouver, WA 98682

Mailing address

5210 SE 112TH Ave
Portland, OR 97266-4182
Phone (503) 888-6077

National Provider Directory

National Provider Directory

Locations

13510 NE 84th St
Ste 105
Vancouver, WA 98682
Phone (360) 696-0000

Practitioners & affiliated clinicians

Practitioners 1

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": "1536019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536105600000",
    "number": "1598247884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 SE 112TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972664182",
            "telephone_number": "503-888-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13510 NE 84TH ST STE 105",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98682",
            "telephone_number": "360-726-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIEP PHAM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-09-05",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "DIEP",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "503-888-6077"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D9395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.