Dr. Phillips Modern Dentistry, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DR. PHILLIPS MODERN DENTISTRY, PA

Doing business as

Doctor Phillips Modern Dentistry

Practice address

8015 Turkey Lake Rd
300
Orlando, FL 32819-7383

Phone

(407) 205-0246

Fax

(407) 641-4041

NPI assigned

Apr 26, 2016

Last updated

Aug 25, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Minh B Pham, DDS

Title

Owner Dentist

Phone

(407) 205-0246

Specialties & licenses 1

Addresses

Other names 1

• Doctor Phillips Modern Dentistry Doing business as

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661385600000",
    "number": "1972958171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "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": "8015 TURKEY LAKE RD",
            "address_2": "300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197383",
            "telephone_number": "407-205-0246",
            "fax_number": "407-641-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. PHILLIPS MODERN DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "MINH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "407-205-0246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctor Phillips Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Doctor Phillips Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Orlando, FL
• Providers in Orlando, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.