NPIMap

Organization Active NPI

Downtown SD Modern Dentistry Dental Group

Doing business as Do and Pham Dental Corporation

  • Dentist
  • San Diego, CA
National Provider Identifier
1952771743
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DOWNTOWN SD MODERN DENTISTRY DENTAL GROUP
Doing business as
Do and Pham Dental Corporation
Practice address
435 4TH Avenue
San Diego, CA 92101
Phone
(619) 850-2550
Fax
(619) 239-1355
NPI assigned
Oct 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Authorized official

Name
Dr. Diana S DO-Yabut, DMD
Title
Owner Doctor
Phone
(619) 850-2550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

435 4TH Avenue
San Diego, CA 92101

Mailing address

17000 Red Hill Avenue
Irvine, CA 92614
Phone (714) 845-8890

Other names 1

  • Do and Pham Dental Corporation Doing business as

National Provider Directory

National Provider Directory

Locations

435 4th Ave
San Diego, CA 92101
Phone (619) 850-2550

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444089600000",
    "number": "1952771743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVENUE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92614",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 4TH AVENUE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92101",
            "telephone_number": "619-850-2550",
            "fax_number": "619-239-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNTOWN SD MODERN DENTISTRY DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A",
        "authorized_official_last_name": "DO-YABUT",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "619-850-2550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Do and Pham Dental Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.