Charles Minh Pham, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DEN03441 Issued in RI

Practice address

1740 Atwood Ave
Johnston, RI 02919-3214

Phone

(401) 233-9800

NPI assigned

Jun 7, 2016

Last updated

Nov 6, 2025By the provider in NPPES

Sex

Male

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

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rhode Island Periodontics

  • Periodontics
  • Johnston, RI
  • NPI 1225908171
  NPD Authorized official

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1699124982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 ATWOOD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193214",
            "telephone_number": "401-233-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 ATWOOD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193214",
            "telephone_number": "401-233-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "CHARLES",
        "middle_name": "MINH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "RI",
            "license": "DEN03441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Lekhana Pereji, MHC-A
• Gail Pereschino, RN
• Julia Perreault, CCC-SLP
• Kristen Marie Peters, LICSW
• Michael Anthony Pezza, D.C.
• Phillip Surgical LLC
• Angela Y Phillip
• John A Phillip, MD
• Jessica L Piccoli
• Katherine Pierce, RN, FNP-C

• Periodontics in Johnston, RI
• Providers in Johnston, RI by specialty
• Periodontics in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.