NPIMap

Organization Active NPI

Shiningstars Pediatric Dentistry PC

  • Pediatric Dentistry
  • Washington, DC
National Provider Identifier
1922738848
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SHININGSTARS PEDIATRIC DENTISTRY PC
Practice address
4301 Connecticut Ave NW Ste 453
Washington, DC 20008-2356
Phone
(202) 470-3676
NPI assigned
Jun 14, 2022
Organization subpart
Yes
Parent organization
SHININGSTARS PEDIATRIC DENTISTRY PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Gina Cuc Pham, DDSNPI 1861525818
Title
President
Phone
(202) 600-4833

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

4301 Connecticut Ave NW Ste 453
Washington, DC 20008-2356

Mailing address

PO Box 10083
MC Lean, VA 22102-8083

Other names 1

  • SHININGSTARS PEDIATRIC DENTISTRY VAN NESS Other name

National Provider Directory

National Provider Directory
Tax ID family
Shiningstars Pediatric Dentistry PC2 organizations share this tax ID, including this one
Part of
Shiningstars Pediatric Dentistry PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1922738848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10083",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221028083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 CONNECTICUT AVE NW STE 453",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200082356",
            "telephone_number": "202-470-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHININGSTARS PEDIATRIC DENTISTRY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHININGSTARS PEDIATRIC DENTISTRY PC",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "CUC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "202-600-4833",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHININGSTARS PEDIATRIC DENTISTRY VAN NESS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.