NPIMap

Organization Active NPI

Phan Dental Corp.

Doing business as Porter Ranch Dental Studio

  • Dentist
  • Porter Ranch, CA
National Provider Identifier
1649597170
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
46927 Issued in CA
Legal business name
PHAN DENTAL CORP.
Doing business as
Porter Ranch Dental Studio
Practice address
11200 Corbin Ave Ste 208
Porter Ranch, CA 91326-4120
Phone
(818) 368-8522
Fax
(818) 368-8544
NPI assigned
Apr 23, 2010
Last updated
Apr 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Authorized official

Name
Dr. Bang Tai Phan, D.D.S.NPI 1851438154
Title
President
Phone
(818) 368-8522

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 46927 CA Primary

Addresses

Primary practice location

11200 Corbin Ave Ste 208
Porter Ranch, CA 91326-4120

Mailing address

11200 Corbin Ave Ste 208
Porter Ranch, CA 91326-4120
Phone (818) 368-8522

Other names 1

  • Porter Ranch Dental Studio Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1649597170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 CORBIN AVE STE 208",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913264120",
            "telephone_number": "818-368-8522",
            "fax_number": "818-368-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 CORBIN AVE STE 208",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913264120",
            "telephone_number": "818-368-8522",
            "fax_number": "818-368-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHAN DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "BANG",
        "authorized_official_middle_name": "TAI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-368-8522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "46927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Porter Ranch Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Porter Ranch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.