Jimmy Bao Pham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

56450 Issued in CA

Practice address

15682 Sleepy Oak Rd
Chino Hills, CA 91709-3841

Phone

(949) 307-8448

NPI assigned

Oct 11, 2007

Sex

Male

Sole proprietor

Yes

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

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.

• Sang C Paik DDS

  • Dentist
  • Corona, CA
  • NPI 1497979280
  NPD (past)
• Wong & Pham DDS, Inc.

  • General Practice Dentistry
  • Corona, CA
  • NPI 1417128034
  NPD (past)

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1972791275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 BEDFORD CANYON RD",
            "address_2": "SUITE 105",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928830789",
            "telephone_number": "951-270-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15682 SLEEPY OAK RD",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093841",
            "telephone_number": "949-307-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JIMMY",
        "middle_name": "BAO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-11",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Person Centered Health Services PC
• Cathy Eileen Peters
• Peterson Chiropractic
• Derrik Brian Peterson, DC
• Diem Quynh Pham, D.O.
• Tiffany Pham, OD
• Uyen Phuong Pham, DDS
• Sara Lauren Phung, DDS
• Phyllis K. Kawada, DDS, Ms, a Professional Corporation
• Derek Pi, OD

• General Practice Dentistry in Chino Hills, CA
• Providers in Chino Hills, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.