Phantastic Smiles PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19016 Issued in TX

Legal business name

PHANTASTIC SMILES PA

Practice address

102 Fairmont Pkwy
Pasadena, TX 77504-2742

Phone

(713) 473-0058

NPI assigned

Oct 21, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Minh Hong Phan, DDS

Title

President

Phone

(713) 473-0058

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1710438049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 FAIRMONT PKWY",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775042742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 FAIRMONT PKWY",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775042742",
            "telephone_number": "713-473-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHANTASTIC SMILES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "MINH",
        "authorized_official_middle_name": "HONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-473-0058",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Bao-Ngoc Phan, MD
• Minh H Phan, DDS
• Thanh Ngoc Phan
• Thuy Phan, PHARM.D.
• Phantastic Family Dental Center (Minh Phan D.D.S PA)
• Pharm Worx RX LLC
• Pharmaxy, LLC.
• PHCC-Paramount Rehabilitation and Health Care Center Pasadena, LLC (Paramount Rehabilitation and Healthcare Center)
• Phlip C Townsend, PH,D., P.C
• Physician Aprroved LLC

• General Practice Dentistry in Pasadena, TX
• Providers in Pasadena, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.