Chieu L Pham, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

52916 Issued in CA

Practice address

12395 El Camino Real Ste 218
San Diego, CA 92130-3084

Phone

(408) 390-7228

NPI assigned

Feb 12, 2007

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

Other names 1

• Chris L Pham Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cpham58384@syhealth.direct-ci.com

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.

• Centro de Salud de la Comunidad de San Ysidro, Inc.

  dba San Ysidro Health Precision Park

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1124782685
  Medicare reassignment NPD
• C Pham & S Mauseth Dental Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chula Vista, CA
  • NPI 1548051287
  NPD Authorized official
• Chieu Pham DDS Inc

  • Pediatric Dentistry
  • San Diego, CA
  • NPI 1740535848
  NPD Authorized official
• Centro de Salud de la Comunidad de San Ysidro Inc

  dba San Ysidro Health Senior Dental Center

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1457033813
  NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  dba San Ysidro Health Chula Vista

  • Federally Qualified Health Center (FQHC)
  • Chula Vista, CA
  • NPI 1326486861
  NPD

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1972645638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12395 EL CAMINO REAL #218",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92130",
            "telephone_number": "408-390-7228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12395 EL CAMINO REAL STE 218",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303084",
            "telephone_number": "408-390-7228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "CHIEU",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "52916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRIS",
            "last_name": "PHAM",
            "middle_name": "L",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anh-Tu Pham
• Anthony Pham
• Anthony Tai Quang Pham, D.D.S.
• Audrey Pham, MD, MPH
• Cassidy Phuong Pham
• Christine Kim Pham, RN
• Christopher Pham, D.D.S.
• Dang Minh Nguyen Pham
• Daniel Pham, PHARMD
• Danielle Pham, OTR/L

• Pediatric Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.