NPIMap

Organization Active NPI

Shiningstars Pediatric Dentistry PC

  • Pediatric Dentistry
  • Washington, DC
National Provider Identifier
1659882595
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SHININGSTARS PEDIATRIC DENTISTRY PC
Practice address
435 Ingraham St NE
Washington, DC 20011
Phone
(202) 600-4833
Fax
(202) 635-5555
NPI assigned
Oct 18, 2017
Last updated
Jun 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Dr. Gina Cuc Pham, DDSNPI 1861525818
Title
President
Phone
(703) 586-7119

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
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

435 Ingraham St NE
Washington, DC 20011

Mailing address

PO Box 10083
McLean, VA 22102
Phone (703) 586-7119

National Provider Directory

National Provider Directory
Tax ID family
Shiningstars Pediatric Dentistry PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

435 Ingraham St NE
Washington, DC 20011
Phone (202) 600-4833

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1508284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1659882595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10083",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "22102",
            "telephone_number": "703-586-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 INGRAHAM ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20011",
            "telephone_number": "202-600-4833",
            "fax_number": "202-635-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHININGSTARS PEDIATRIC DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-18",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "CUC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-586-7119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.