La Costa of Port Arthur PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22334 Issued in TX

Legal business name

LA COSTA OF PORT ARTHUR PA

Practice address

8035 Memorial Blvd
Port Arthur, TX 77640-7002

Phone

(972) 514-1689

NPI assigned

May 12, 2016

Last updated

Oct 8, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tien Dinh Phan, DMD

Title

Dentist

Phone

(956) 507-7253

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791417600000",
    "number": "1942656509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 REGENT BLVD STE 110",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633107",
            "telephone_number": "956-507-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8035 MEMORIAL BLVD",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776407002",
            "telephone_number": "972-514-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA COSTA OF PORT ARTHUR PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-12",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "TIEN",
        "authorized_official_middle_name": "DINH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "956-507-7253",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Port Arthur, TX
• Providers in Port Arthur, 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 Oct 8, 2026; 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.