Active NPI
Christine Huong Phan, DDS
- Dentist
- New York, NY
National Provider Identifier
1902953805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 046961
- Practice address
- 161 Madison Ave
Suite 8 SW
New York, NY 10016-5421 - Phone
- (212) 686-7077
- Fax
- (815) 642-7487
- NPI assigned
- Jan 4, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 046961 | NY | Primary |
Addresses
Primary practice location
161 Madison Ave
Suite 8 SW
New York, NY 10016-5421
Mailing address
161 Madison Ave
Suite 8 SW
New York, NY 10016-5421
Phone (212) 686-7077
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 |
|---|---|---|---|
| 046961 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206921600000",
"number": "1902953805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 MADISON AVE",
"address_2": "SUITE 8 SW",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100165421",
"telephone_number": "212-686-7077",
"fax_number": "815-642-7487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 MADISON AVE",
"address_2": "SUITE 8 SW",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100165421",
"telephone_number": "212-686-7077",
"fax_number": "815-642-7487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "CHRISTINE",
"middle_name": "HUONG",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2008-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "046961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.