Active NPI
Thinh Sy-Quoc Pham, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Tyler, TX
National Provider Identifier
1609213396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 29009
- Practice address
- 1932 E SE Loop 323
Tyler, TX 75701-8337 - Phone
- (469) 879-6795
- NPI assigned
- Jun 4, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 29009 | TX | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 29009 | TX | Primary |
Addresses
Primary practice location
1932 E SE Loop 323
Tyler, TX 75701-8337
Mailing address
5200 Martel Ave Apt 21D
Dallas, TX 75206-5647
Phone (469) 879-6795
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 |
|---|---|---|---|
| 29009 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1609213396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 MARTEL AVE APT 21D",
"city": "DALLAS",
"state": "TX",
"postal_code": "752065647",
"telephone_number": "469-879-6795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1932 E SE LOOP 323",
"city": "TYLER",
"state": "TX",
"postal_code": "757018337",
"telephone_number": "469-879-6795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "THINH",
"middle_name": "SY-QUOC",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-04",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "29009",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "29009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.