Tiffany Lan Pham

Primary specialty

DentistTaxonomy code 122300000X

License

34115 Issued in TX

Practice address

967 N Garden Ridge Blvd
Lewisville, TX 75077-2800

Phone

(972) 537-5730

NPI assigned

Jun 11, 2018

Last updated

Jun 11, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• TK Dental PLLC

  dba Vida Family Dentistry

  • General Practice Dentistry
  • Garland, TX
  • NPI 1295587780
  NPD

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1619460193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 BENNINGTON DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760181915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "967 N GARDEN RIDGE BLVD",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750772800",
            "telephone_number": "972-537-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TIFFANY",
        "middle_name": "LAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "34115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Petrie, APRN
• Peyton Shaw Counseling
• Kathleen Huan Pham, D.M.D
• Ky-Van Pham
• Nikki Minh Pham, PT
• Tony Pham, RPH
• Trinh L. Pham, NP-C
• Cindy Phan
• Pharmara Labs LLC (Formulation Compounding Center)
• Blessy Philip, O.D.

• Dentist in Lewisville, TX
• Providers in Lewisville, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.