NPIMap

Organization Active NPI

Minh Pham and Diana DO Dental Corporation

Doing business as East Village Dental Group

  • Dentist
  • San Diego, CA
National Provider Identifier
1710351739
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MINH PHAM AND DIANA DO DENTAL CORPORATION
Doing business as
East Village Dental Group
Practice address
1455 G St.
San Diego, CA 92101
Phone
(619) 324-4981
Fax
(619) 399-7107
NPI assigned
Nov 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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

Authorized official

Name
Dr. Minh B Pham, DDS
Title
Owner
Phone
(619) 324-4981

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1455 G St.
San Diego, CA 92101

Mailing address

17000 Red Hill Avenue
Irvine, CA 92614
Phone (714) 845-8890

Other names 1

  • East Village Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

1455 G St
San Diego, CA 92101
Phone (619) 324-4981

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447632000000",
    "number": "1710351739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVENUE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92614",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 G ST.",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92101",
            "telephone_number": "619-324-4981",
            "fax_number": "619-399-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINH PHAM AND DIANA DO DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-16",
        "last_updated": "2015-11-16",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "MINH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-324-4981",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Village Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; 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.