NPIMap

Organization Active NPI

Gina C Pham DDS PC

Doing business as Britestars Pediatric Dentistry

  • Pediatric Dentistry
  • Woodbridge, VA
National Provider Identifier
1801029590
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401411775 Issued in VA
Legal business name
GINA C PHAM DDS PC
Doing business as
Britestars Pediatric Dentistry
Practice address
12602 Lake Ridge Dr
Woodbridge, VA 22192-2335
Phone
(703) 490-5050
NPI assigned
Aug 27, 2009
Last updated
Feb 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Authorized official

Name
Dr. Gina C Pham, DDSNPI 1861525818
Title
Pediatric Dentist
Phone
(703) 490-5050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 0401411775 VA Primary

Addresses

Primary practice location

12602 Lake Ridge Dr
Woodbridge, VA 22192-2335

Mailing address

PO Box 10083
MC Lean, VA 22102-8083
Phone (703) 626-8196

Other practice location 1

13900 Noblewood Plz
Woodbridge, VA 22193-1449
Phone (703) 490-5060

Other names 1

  • BRITESTARS PEDIATRIC DENTISTRY Doing business as

National Provider Directory

National Provider Directory

Locations

12602 Lake Ridge Dr
Woodbridge, VA 22192
Phone (703) 490-5050

13900 Noblewood Plz
Woodbridge, VA 22193
Phone (703) 490-5050

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1801029590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10083",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221028083",
            "telephone_number": "703-626-8196"
        },
        {
            "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": "221922335",
            "telephone_number": "703-490-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13900 Noblewood Plz",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221931449",
            "country_code": "US",
            "telephone_number": "703-490-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GINA C PHAM DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "703-490-5050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401411775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRITESTARS PEDIATRIC DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.