Healthcare Provider Details

I. General information

NPI: 1699685651
Provider Name (Legal Business Name): SHARON PHAMDUONG, DDS, MS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 TORRANCE BLVD STE 450
TORRANCE CA
90503-4592
US

IV. Provider business mailing address

4201 TORRANCE BLVD STE 450
TORRANCE CA
90503-4592
US

V. Phone/Fax

Practice location:
  • Phone: 310-540-1415
  • Fax:
Mailing address:
  • Phone: 310-540-1415
  • Fax: 310-540-1423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. SHARON PHAMDUONG
Title or Position: OWNER
Credential: DDS, MS
Phone: 310-540-1415