Vu Pham, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN25033 Issued in FL

Practice address

1761 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5479

Phone

(772) 335-0993

NPI assigned

Jul 21, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• David J. Krynauw, DDS, PA

  • Dental Clinic/Center
  • Port St Lucie, FL
  • NPI 1699032490
  NPD (past)

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1891303335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 BEL AIR AVE",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330627734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 SE PORT ST LUCIE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525479",
            "telephone_number": "772-335-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "VU",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Petkunas Byrne
• Mariela Petraki
• Bambi Petrinic, M.D.
• Adam Joseph Petrone, DC
• Dominique Petrone, DMD
• Celestina Marie Silvas Phoebus, M.S.
• Phoenix House of Hope Inc
• Phoenix House of Hope Inc
• Phoenix Resolutions Treatment Center
• Phoenix Resolutions Treatment Facility

• General Practice Dentistry in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.