Active NPI
Hung Duy Pham, DDS
- Pediatric Dentistry
- San Bruno, CA
National Provider Identifier
1851498968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 46514
- Practice address
- 1001 San Bruno Ave W
San Bruno, CA 94066-3318 - Phone
- (650) 989-9299
- Fax
- (650) 989-9257
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 46514 | CA | Primary |
Addresses
Primary practice location
1001 San Bruno Ave W
San Bruno, CA 94066-3318
Mailing address
1001 San Bruno Ave W
San Bruno, CA 94066-3318
Phone (650) 989-9299
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46514 | CA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Belluomini & West, DDS | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Daly City, CA
- NPI 1588399604
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640044800000",
"number": "1851498968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 SAN BRUNO AVE W",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940663318",
"telephone_number": "650-989-9299",
"fax_number": "650-989-9257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 SAN BRUNO AVE W",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940663318",
"telephone_number": "650-989-9299",
"fax_number": "650-989-9257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "HUNG",
"middle_name": "DUY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2021-12-21",
"certification_date": "2021-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "46514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bruno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.