Active NPI
Minh Phan DDS PA
- Dentist
- Pasadena, TX
National Provider Identifier
1659596641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 19016
- Legal business name
- MINH PHAN DDS PA
- Practice address
- 123 W Southmore
Pasadena, TX 77502 - Phone
- (713) 473-0058
- Fax
- (713) 473-0636
- NPI assigned
- Apr 16, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Minh H Phan
- Title
- President
- Phone
- (713) 473-7223
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 19016 | TX | Primary |
Addresses
Primary practice location
123 W Southmore
Pasadena, TX 77502
Mailing address
905 Southmore
Pasadena, TX 77502
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180693701 | Medicaid | TX | |
| G6010102 | Other | TX | DELTA DENTAL |
National Provider Directory
National Provider Directory- Tax ID family
- Minh Phan DDS PA
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dentist
- Galena Park, TX
- NPI 1639393804
-
- Dentist
- Pasadena, TX
- NPI 1740405737
Locations
123 W Southmore Ave
Pasadena, TX 77502
Phone (713) 473-0058
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Pasadena, TX
- NPI 1003217852
-
- General Practice Dentistry
- Houston, TX
- NPI 1447489463
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1320710400000",
"number": "1659596641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 SOUTHMORE",
"city": "PASADENA",
"state": "TX",
"postal_code": "77502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 W SOUTHMORE",
"city": "PASADENA",
"state": "TX",
"postal_code": "77502",
"telephone_number": "713-473-0058",
"fax_number": "713-473-0636"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MINH PHAN DDS PA",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-16",
"last_updated": "2011-11-08",
"status": "A",
"authorized_official_last_name": "PHAN",
"authorized_official_first_name": "MINH",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "713-473-7223",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "TX",
"license": "19016",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "180693701",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL",
"identifier": "G6010102",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.