Active NPI
Tuan Pham, D.M.D.
- Dentist
- Vienna, VA
National Provider Identifier
1720206451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401410688
- Practice address
- 307 Maple Ave W Ste M
Vienna, VA 22180-4307 - Phone
- (703) 281-1090
- NPI assigned
- Apr 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 0401410688 | VA | Primary |
Addresses
Primary practice location
307 Maple Ave W Ste M
Vienna, VA 22180-4307
Mailing address
307 Maple Ave W Ste M
Vienna, VA 22180-4307
Phone (703) 281-1090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- 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 |
|---|---|---|---|---|
| I20160415002087 | MD | Order and Referring Only - Dentist | 8729386297 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401410688 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pham, Biga & Maloney, PLLC | Dentist | Past | Accepting new patients |
| Rogowski and Maloney Partnership | Dentist | Past | Accepting new patients |
| Tuan D Pham DMD & Joseph a Maloney DDS, LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
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- Vienna, VA
- NPI 1437684263
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- Waldorf, MD
- NPI 1558364208
-
- Dentist
- Vienna, VA
- NPI 1336267988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726963200000",
"number": "1720206451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 MAPLE AVE W STE M",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804307",
"telephone_number": "703-281-1090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 MAPLE AVE W STE M",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804307",
"telephone_number": "703-281-1090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "TUAN",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-20",
"last_updated": "2024-09-22",
"certification_date": "2024-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401410688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2024; 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.