NPIMap

Organization Active NPI

Phan Dental Group

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Dublin, CA
National Provider Identifier
1982357281
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
PHAN DENTAL GROUP
Practice address
7048 Dublin Blvd
Dublin, CA 94568-3017
Phone
(925) 833-0535
NPI assigned
Jan 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Authorized official

Name
Dr. H. Derick Phan, DDS
Title
Owner
Phone
(408) 251-7901

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X
Oral and Maxillofacial Radiology DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0008X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

7048 Dublin Blvd
Dublin, CA 94568-3017

Mailing address

150 N Jackson Ave Ste 211
San Jose, CA 95116-1908
Phone (408) 251-7901

Other names 1

  • Atlantis Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

7048 Dublin Blvd
Dublin, CA 94568
Phone (925) 833-0535

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1982357281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N JACKSON AVE STE 211",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161908",
            "telephone_number": "408-251-7901",
            "fax_number": "408-251-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7048 DUBLIN BLVD",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945683017",
            "telephone_number": "925-833-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHAN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-27",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "H. DERICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-251-7901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlantis Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dublin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.