Active NPI
Van Thi-Kim Phan, DDS
- Dentist
- Long Beach, CA
National Provider Identifier
1952008054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 108579
- Practice address
- 2306 E 7TH St
Long Beach, CA 90804-4619 - Phone
- (562) 434-0740
- NPI assigned
- Feb 9, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 108579 | CA | Primary |
Addresses
Primary practice location
2306 E 7TH St
Long Beach, CA 90804-4619
Mailing address
4608 Larwin Ave
Cypress, CA 90630-3511
Phone (612) 598-3397
Other practice location 1
10120 Garden Grove Blvd
Garden Grove, CA 92844-1687
Phone (714) 591-5139
Other practice location 2
1030 University Ave W
Saint Paul, MN 55104-4706
Phone (651) 239-7495
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 108579 | CA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Dental Services, Inc. | Dentist | Past | Accepting new patients |
| Cherag Dinshaw Sarkari DDS a Dental Corporation | Past | Accepting new patients |
Interoperability endpoints
- van.phan.p1@direct.tmwihc.nextgenshare.com
Organizations & group practices 2
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.
-
dba Blue Hills Dental
- General Practice Dentistry
- Long Beach, CA
- NPI 1477925683
-
- Dentist
- Long Beach, CA
- NPI 1427522812
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788739200000",
"number": "1952008054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4608 LARWIN AVE",
"city": "CYPRESS",
"state": "CA",
"postal_code": "906303511",
"telephone_number": "612-598-3397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2306 E 7TH ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908044619",
"telephone_number": "562-434-0740"
}
],
"practiceLocations": [
{
"address_1": "10120 Garden Grove Blvd",
"address_purpose": "LOCATION",
"city": "Garden Grove",
"state": "CA",
"postal_code": "928441687",
"country_code": "US",
"telephone_number": "714-591-5139",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1030 University Ave W",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551044706",
"country_code": "US",
"telephone_number": "651-239-7495",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHAN",
"first_name": "VAN",
"middle_name": "THI-KIM",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-09",
"last_updated": "2026-09-07",
"certification_date": "2026-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "108579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.