Anh Huu Pham, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0401006304 Issued in VA

Practice address

19441 Golf Vista Plaza
Suite 130
Lansdowne, VA 20176

Phone

(703) 723-7858

Fax

(703) 723-7882

NPI assigned

Jun 15, 2006

Last updated

Aug 21, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 14, 2012 through Dec 14, 2026

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anh H Pham DDS & Barry R Maharaj DDS PC

  dba Chantilly Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Chantilly, VA
  • NPI 1265547947
  NPD (past)
• Barry R. Maharaj, DDS & Anh H. Pham, DDS, PC

  dba Lansdowne Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Lansdowne, VA
  • NPI 1093889008
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1750325361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19441 GOLF VISTA PLAZA",
            "address_2": "SUITE 130",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "20176",
            "telephone_number": "703-723-7858",
            "fax_number": "703-723-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19441 GOLF VISTA PLAZA",
            "address_2": "SUITE 130",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "20176",
            "telephone_number": "703-723-7858",
            "fax_number": "703-723-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "ANH",
        "middle_name": "HUU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "VA0404006304",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0438000026",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401006304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008000841",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Micah J Park, MD
• A. Carminda Passino, MSSW
• Vishal Anil Patel, MD
• Kristen Patrick
• Kathleen Waggoner Petty, LCSW, CSAC
• Cameron Lee Phipps, D.P.M.
• Physical Medicine Associates LTD (National Spine & Pain Centers)
• Physicians Practice and Research, LLC
• Physicians' Ai Inc
• Helena Marshall Pittman, CCC-SLP

• Oral and Maxillofacial Surgery (Dentist) in Lansdowne, VA
• Providers in Lansdowne, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.