Phan, Rawlins & Lyons DDS Inc

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

56958 Issued in CA

Legal business name

PHAN, RAWLINS & LYONS DDS INC

Doing business as

Surfside Kids Dental

Practice address

6942 Almaden Expy # 11
San Jose, CA 95120-3201

Phone

(480) 235-8541

NPI assigned

Mar 23, 2016

Organization subpart

No

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

Authorized official

Name

Joseph Rawlins, DDS

Title

President

Phone

(916) 229-9941

Specialties & licenses 2

Addresses

Other names 1

• Surfside Kids Dental Doing business as

Locations

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1942662457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4785",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957620024",
            "telephone_number": "916-229-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6942 ALMADEN EXPY # 11",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951203201",
            "telephone_number": "480-235-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHAN, RAWLINS & LYONS DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "RAWLINS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-229-9941",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "56958",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "51968",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surfside Kids Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kieu Nhi Phan
• Martin Phan, MD
• Nancy D Phan, DDS MS
• Phuong Phan
• Quynh Ngoc Phan
• Sadie Phan, MS, OTR/L
• Sally Ngoc Phan, PHARM-D
• Sonny Phan, MPT
• Tammy Minh Phan, RBT
• Thanh Tam Le Phan, PHARMD

• Pediatric Dentistry in San Jose, CA
• Providers in San Jose, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; 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.