Kim Thanh Thi Pham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

44986 Issued in CA

Practice address

10102 Valley View St
Buena Park, CA 90620-4344

Phone

(714) 229-4898

Fax

(714) 229-4899

NPI assigned

Mar 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kimthanh Thi Pham Other name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922122373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12247 YEARLING PL",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907037658",
            "telephone_number": "714-229-4898",
            "fax_number": "714-229-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10102 VALLEY VIEW ST",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204344",
            "telephone_number": "714-229-4898",
            "fax_number": "714-229-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KIM",
        "middle_name": "THANH THI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMTHANH",
            "last_name": "PHAM",
            "middle_name": "THI",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cassandra Anne Peterson-Solano
• Petra Healthcare Inc
• Trisha Pfeiffer
• Evan Pham
• Huong Quynh Pham, PHARM. D.
• Minh H. Pham, D.P.T.
• Dana Y Phan, O.D.
• Laura Phillips, M.S. SLP
• Physician Healthcare Integration Ipa
• Maria Rachel Gatchalian Pia

• General Practice Dentistry in Buena Park, CA
• Providers in Buena Park, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.