Shine Pearl Dental and Associates PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SHINE PEARL DENTAL AND ASSOCIATES PLLC

Practice address

2445 Fulton St Ste B
Houston, TX 77009-7837

Phone

(713) 225-2266

NPI assigned

Aug 4, 2022

Organization subpart

Yes

Parent organization

SHINE PEARL DENTAL AND ASSOCIATES PLLCAs reported in NPPES

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

Authorized official

Name

Dr. Minh Chau Pham, DMDNPI 1427629021

Title

Owner/Dentist

Phone

(713) 225-2266

Specialties & licenses 2

Addresses

Other names 1

• Fulton Dental Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Part of

Shine Pearl Dental and Associates PLLC

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Minh Chau Thi Pham

  • General Practice Dentistry
  • Pampa, TX
  • NPI 1427629021
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1891422309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S MILLBEND DR APT 4105",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773801889",
            "telephone_number": "267-368-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 FULTON ST STE B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770097837",
            "telephone_number": "713-225-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE PEARL DENTAL AND ASSOCIATES PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHINE PEARL DENTAL AND ASSOCIATES PLLC",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "MINH CHAU",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "713-225-2266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fulton Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fulton Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Jung-Sook Kim Shin
• Sandra Shin, AA
• Suzanne Shin
• Shine Bright Family Services LLC
• Shine M.D., P.a.
• Jade Shine, OT
• Shinemd Medical Group, PLLC
• Shashi Shekhar Shingh
• Shining Nightingale Inc
• Mary Natalie Shinn, MD

• General Practice Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.