Linh Phan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401416238 Issued in VA

Practice address

12602 Lake Ridge Dr
Woodbridge, VA 22192

Phone

(703) 490-5050

NPI assigned

Jun 2, 2017

Sex

Female

Sole proprietor

Yes

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

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.

• Gina C Pham DDS PC

  dba Britestars Pediatric Dentistry

  • Pediatric Dentistry
  • Woodbridge, VA
  • NPI 1801029590
  NPD (past)

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1710415716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 CRYSTAL DR APT 323",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222024103",
            "telephone_number": "720-987-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12602 LAKE RIDGE DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22192",
            "telephone_number": "703-490-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 E Tampa St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658061131",
            "country_code": "US",
            "telephone_number": "417-831-0150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "440 E Tampa St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658061131",
            "country_code": "US",
            "telephone_number": "417-831-0150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "LINH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-02",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Scott Petruzzi, D.C.
• Gina Cuc Pham, DDS
• Nhu-Oanh Thi Pham, PHARMD
• Shawn Ngoc Pham, MSW, LCSW
• Teresa Diemtu Pham, O.D.
• Thoaivan Phan, D.D.S
• Pharmacy One LLC (Pharmacy One)
• Abigail Atienza Phillips, CRNP
• Brenda Phoeuk, OT
• Phuong Ngoc Nguyen DMD, PLLC. (Woodbridge Oral & Maxillofacial Surgery Center)

• General Practice Dentistry in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; 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.