Sara Hoangsa Fam, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12972 Issued in MN

Practice address

800 Prairie Center Drive
Suite 250
Eden Prairie, MN 55344-7328

Phone

(952) 974-5116

Fax

(952) 903-0012

NPI assigned

Aug 8, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Hoang Sa Han Pham Former name

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.

• Molldrem Family Dentistry

  • General Practice Dentistry
  • Eden Prairie, MN
  • NPI 1326173279
  NPD (past)

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1992084909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 PRAIRIE CENTER DRIVE",
            "address_2": "SUITE 250",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447339",
            "telephone_number": "952-974-5116",
            "fax_number": "952-903-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRAIRIE CENTER DRIVE",
            "address_2": "SUITE 250",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447328",
            "telephone_number": "952-974-5116",
            "fax_number": "952-903-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAM",
        "first_name": "SARA",
        "middle_name": "HOANGSA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOANG SA",
            "last_name": "PHAM",
            "middle_name": "HAN",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• General Practice Dentistry in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.