Andrew Christopher Pham, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11600 Issued in OR

Practice address

712 Jay St
Fossil, OR 97830-8371

Phone

(541) 723-2725

NPI assigned

Oct 4, 2022

Last updated

Oct 4, 2022By the provider in NPPES

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

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1972228831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14730 SE FRYE ST",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970862837",
            "telephone_number": "971-533-9161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 JAY ST",
            "city": "FOSSIL",
            "state": "OR",
            "postal_code": "978308371",
            "telephone_number": "541-723-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "ANDREW",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanorah Brighid McDonald, FNP AGACNP
• Tara McIntosh
• Northeast Wheeler County Health (Asher Home Health Services)
• Makaila Samonne-Hunt Palazo, PA-C
• Maryhelen I Peterson, QMHP
• Janet Leee Ridgley, WHCNP/FNP
• Amanda Ann Roy, PA-C
• Brian Schaudt, PT
• Debra Ruth Stubblefield, RN BSN
• Wheeler County Public Health

• General Practice Dentistry in Fossil, OR
• Providers in Fossil, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.