Dominique S Pham, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

104991 Issued in CA

Practice address

7046 Dublin Blvd
Dublin, CA 94568-3017

Phone

(925) 828-9811

NPI assigned

Jul 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• James Huang DMD Inc.

  • Preferred Provider Organization
  • Dublin, CA
  • NPI 1669073904
  NPD
• Dental Corporation of Amardeep Gill DDS

  • General Practice Dentistry
  • West Sacramento, CA
  • NPI 1184874026
  NPD (past)

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1942828546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 JOAQUIN AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945775116",
            "telephone_number": "510-499-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7046 DUBLIN BLVD",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945683017",
            "telephone_number": "925-828-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "DOMINIQUE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "104991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebekah Peterson
• Steven Mark Peterson, LCSW #23821
• Jack Petrin
• Amy Petrovich
• Nancy N Pham-Thomas, MD
• Phan Dental Group
• Delton Phan
• Natasha Phan, MD
• Rocky Phan
• Maylene Han Phangureh, D.O.

• Dentist in Dublin, CA
• Providers in Dublin, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.