Active NPI
Thanh Pham
- General Practice Dentistry
- Dade City, FL
National Provider Identifier
1700947660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN15319
- Practice address
- 37944 Pasco Ave
Dade City, FL 33525-4202 - Phone
- (352) 518-2000
- Fax
- (352) 567-0218
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN15319 | FL | Primary |
Addresses
Primary practice location
37944 Pasco Ave
Dade City, FL 33525-4202
Mailing address
37944 Pasco Ave
Dade City, FL 33525-4202
Phone (352) 518-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160628002718 | FL | Order and Referring Only - Dentist | 8729379342 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN15319 | FL | MD | General Practice Dentistry |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464048000000",
"number": "1700947660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37944 PASCO AVE",
"city": "DADE CITY",
"state": "FL",
"postal_code": "335254202",
"telephone_number": "352-518-2000",
"fax_number": "352-567-0218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37944 PASCO AVE",
"city": "DADE CITY",
"state": "FL",
"postal_code": "335254202",
"telephone_number": "352-518-2000",
"fax_number": "352-567-0218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "THANH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2016-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN15319",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dade City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.