Reseda Village Dental Studio

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

54191 Issued in CA

Legal business name

RESEDA VILLAGE DENTAL STUDIO

Practice address

18700 Sherman Way Ste 116
Reseda, CA 91335-9101

Phone

(818) 757-7070

Fax

(818) 757-7788

NPI assigned

Feb 25, 2010

Organization subpart

No

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

Authorized official

Name

Charmaine Marie Alexander

Title

Office Manager

Phone

(818) 757-7070

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Tu Thanh Pham, D.D.S.

  • General Practice Dentistry
  • Tarzana, CA
  • NPI 1770796831
  NPD (past)

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

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267056000000",
    "number": "1639491004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18700 SHERMAN WAY STE 116",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913359101",
            "telephone_number": "818-757-7070",
            "fax_number": "818-757-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 SHERMAN WAY STE 116",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913359101",
            "telephone_number": "818-757-7070",
            "fax_number": "818-757-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESEDA VILLAGE DENTAL STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-25",
        "last_updated": "2010-02-25",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "CHARMAINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "818-757-7070"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "54191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "525031",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reseda Pharmacy Inc
• Reseda Ranch
• Reseda Recovery Center Inc
• Reseda Senior Living
• Reseda Urgent Care, Inc.
• Rest and Rise Recovery
• Alondra Reyes
• Beatriz Alysson Reyes
• Eulalia Miranda Reyes
• Brianna Esmeralda Reynoso, M.A.

• Preferred Provider Organization in Reseda, CA
• Providers in Reseda, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; 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.