Jimmy Duy Pham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

110090 Issued in CA

Practice address

2270 Camino Ramon
Suite 100
San Ramon, CA 94583

Phone

(925) 866-1777

NPI assigned

Apr 4, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Anthony H Nguyen Dentist Inc

  dba Pro Smile Dental Care

  • General Practice Dentistry
  • San Ramon, CA
  • NPI 1154703049
  NPD
• Sones Family Dental, LLC

  • Dentist
  • Glen Carbon, IL
  • NPI 1700206406
  NPD (past)
• Troy Dental Associates LLC

  • Dentist
  • Troy, IL
  • NPI 1801758446
  NPD (past)

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

{
    "created_epoch": "1617494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1659950087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 CAMINO RAMON",
            "address_2": "SUITE 100",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "94583",
            "telephone_number": "925-866-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 CAMINO RAMON",
            "address_2": "SUITE 100",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "94583",
            "telephone_number": "925-866-1777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "627 S Truman Blvd",
            "address_purpose": "LOCATION",
            "city": "Festus",
            "state": "MO",
            "postal_code": "630282234",
            "country_code": "US",
            "telephone_number": "636-937-7920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5835 E Still Cir",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852063618",
            "country_code": "US",
            "telephone_number": "480-248-8107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JIMMY",
        "middle_name": "DUY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-04",
        "last_updated": "2025-08-07",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2022022932",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raquel Peterson
• Hallie Pettibone
• Amanda Pham
• Anne Pham
• Corey Pham
• Thomas B Pham, PHARM. D.
• Alan Phan, PHARMD
• H. Derick Phan, D.D.S., C.A.G.S.
• Serena Phelan
• Philip Yee, MD, Inc.

• General Practice Dentistry in San Ramon, CA
• Providers in San Ramon, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.