Active NPI
Melissa Pham
- Dental Hygienist
- Jacksonville, FL
National Provider Identifier
1851994958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 27900
- Practice address
- 445 State Road 13
Jacksonville, FL 32259-3838 - Phone
- (904) 209-6590
- NPI assigned
- Nov 19, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 27900 | FL | Primary |
Addresses
Primary practice location
445 State Road 13
Jacksonville, FL 32259-3838
Mailing address
1357 Marsh Grass CT
Jacksonville, FL 32218-8646
Phone (773) 742-4164
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 |
|---|---|---|---|
| 27900 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605744000000",
"number": "1851994958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1357 MARSH GRASS CT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322188646",
"telephone_number": "773-742-4164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 STATE ROAD 13",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322593838",
"telephone_number": "904-209-6590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-19",
"last_updated": "2020-11-19",
"certification_date": "2020-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "FL",
"license": "27900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.