Michael Tung Pham, DMD, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4769 Issued in NV

Legal business name

MICHAEL TUNG PHAM, DMD, PC

Doing business as

Eastern Hills Dental

Practice address

5905 S Eastern Ave
Suite 112
Las Vegas, NV 89119-3129

Phone

(702) 262-5693

NPI assigned

Dec 10, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Michael Tung Pham, DMD

Title

Dentist/President/Owner

Phone

(702) 262-5693

Specialties & licenses 1

Addresses

Other names 1

• Eastern Hills Dental Doing business as

Locations

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260403200000",
    "number": "1871822486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 S EASTERN AVE",
            "address_2": "SUITE 112",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891193129",
            "telephone_number": "702-262-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 S EASTERN AVE",
            "address_2": "SUITE 112",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891193129",
            "telephone_number": "702-262-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL TUNG PHAM, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2009-12-10",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "MICHAEL TUNG",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT/OWNER",
        "authorized_official_telephone_number": "702-262-5693",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Hills Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.