Active NPI
Truc Thanh Pham, RDH, DT
- Dental Therapist
- Saint Paul, MN
National Provider Identifier
1629707187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Therapist
- License
- DY148
- Practice address
- 895 7TH St E
Saint Paul, MN 55106-3871 - Phone
- (651) 602-7500
- NPI assigned
- Jun 8, 2022
- 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 |
|---|---|---|---|---|
| Dental Therapist | 125J00000X | DY148 | MN | Primary |
Addresses
Primary practice location
895 7TH St E
Saint Paul, MN 55106-3871
Mailing address
1005 Gramsie Rd Apt 307
Shoreview, MN 55126-3126
Phone (651) 206-4072
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 |
|---|---|---|---|
| DY148 | MN | MD | Dental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654646400000",
"number": "1629707187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 GRAMSIE RD APT 307",
"city": "SHOREVIEW",
"state": "MN",
"postal_code": "551263126",
"telephone_number": "651-206-4072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "895 7TH ST E",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551063871",
"telephone_number": "651-602-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "TRUC",
"middle_name": "THANH",
"credential": "RDH, DT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-08",
"last_updated": "2022-06-08",
"certification_date": "2022-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "125J00000X",
"taxonomy_group": "",
"desc": "Dental Therapist",
"state": "MN",
"license": "DY148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.