Shawn Pham, DDS, PLLC.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SHAWN PHAM, DDS, PLLC.

Practice address

10209 Bridgeport Way SW Ste B10
Lakewood, WA 98499-2327

Phone

(253) 222-9269

NPI assigned

Dec 13, 2023

Organization subpart

No

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

Authorized official

Name

Shawn Pham, DDSNPI 1972171866

Title

Sole Member

Phone

(253) 222-9269

Specialties & licenses 1

Addresses

Other names 1

• Luna Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shawn Lou Pham, DDS

  • Dentist
  • Burien, WA
  • NPI 1972171866
  NPD Authorized official

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1669240263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 DUVALL AVE NE APT R1323",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980594775",
            "telephone_number": "253-222-9269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10209 BRIDGEPORT WAY SW STE B10",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992327",
            "telephone_number": "253-222-9269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWN PHAM, DDS, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "253-222-9269",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Luna Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Sharrah
• Shannon May Shattuck, BA
• Anthony Shaw
• Hope Shaw
• Michael Haylett Shaw, HS
• Jesssica Rose Sheinbaum
• Janie Shelby
• Malisa Shellman
• Janet R Shelstad, MA, LMFT
• Diane Ree Shepard, MA, LMHC

• Dental Clinic/Center in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.