Mary Pham Ikeda DDS Ms Inc

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MARY PHAM IKEDA DDS MS INC

Doing business as

Lollipop Pediatric Dentistry & Orthodontics

Practice address

4251 Long Beach Blvd Unit C
Long Beach, CA 90807-2003

Phone

(714) 528-8252

NPI assigned

Dec 22, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Mary Regina Pham, DDS MS

Title

Ceo Pediatric Dentisty

Phone

(714) 528-8252

Specialties & licenses 2

Addresses

Other names 1

• Lollipop Pediatric Dentistry & Orthodontics Doing business as

Locations

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1881281913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 HARBOR BLVD STE B6",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265121",
            "telephone_number": "714-528-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 LONG BEACH BLVD UNIT C",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072003",
            "telephone_number": "714-528-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY PHAM IKEDA DDS MS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "REGINA",
        "authorized_official_title_or_position": "CEO PEDIATRIC DENTISTY",
        "authorized_official_telephone_number": "714-528-8252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lollipop Pediatric Dentistry & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.

Verify at the official NPI Registry.