Khanh Mai Ngoc Pham, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11524 Issued in OR

Practice address

19129 Beavercreek Rd
Oregon City, OR 97045-9539

Phone

(503) 305-5051

NPI assigned

Aug 30, 2021

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

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

• Livingston DDS of Oregon LLC

  • General Practice Dentistry
  • Albany, OR
  • NPI 1417461328
  NPD (past)
• Pioneer Dental Group PC

  • General Practice Dentistry
  • Oregon City, OR
  • NPI 1205213303
  NPD (past)

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1649947367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19129 BEAVERCREEK RD",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970459539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19129 BEAVERCREEK RD",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970459539",
            "telephone_number": "503-305-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KHANH",
        "middle_name": "MAI NGOC",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Peterson, LMT
• Mara B Peterson, MD
• Shana K Peyser, MSW
• Maret Pfohman, PMHNP
• James Pham, PHARMD
• Nicole Phelps, LCSW
• Brittany Picardo
• Steven Andrew Pierson, P.T.
• Halee Love Pilcher
• Raleigh Scott Pioch, DDS

• General Practice Dentistry in Oregon City, OR
• Providers in Oregon City, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.

Verify at the official NPI Registry.