Shawn Lou Pham, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DENT.DE.61184555 Issued in WA

Practice address

14212 Ambaum Blvd SW Ste 1
Burien, WA 98166-1437

Phone

(206) 343-0000

NPI assigned

Jun 16, 2021

Sex

Male

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.

• Shawn Pham, DDS, PLLC.

  • Dental Clinic/Center
  • Lakewood, WA
  • NPI 1669240263
  NPD Authorized official

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1972171866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 DUVALL AVE NE APT R1323",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980594775",
            "telephone_number": "253-222-9269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14212 AMBAUM BLVD SW STE 1",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661437",
            "telephone_number": "206-343-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "SHAWN",
        "middle_name": "LOU",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DENT.DE.61184555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheri Lynn Peterson-Buckley, MD
• Christine Lee Peterson, LICSW
• Christina Petty
• Pham T Huynh V Huynh PLLC
• Andrea Pham
• Thien-Kim Pham
• Lai Phuc Phan, PHARMD
• Nam Van Phan
• Quynh-Anh Phan, ARNP
• Dorothy Winkler Phelps, RN

• Dentist in Burien, WA
• Providers in Burien, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.