NPI Code Detail JSON Logo

1093199598 NPI number — ELISE PHAM DMD

NPI Number: 1093199598
Health Care Provider/Practitioner: ELISE PHAM DMD

Information about “1093199598” NPI (ELISE PHAM DMD) exists in 1093199598 in HTML format HTML  |  1093199598 in plain Text format TXT  |  1093199598 in PDF (Portable Document Format) PDF  |  1093199598 in an XML format XML  formats.

NPI Number : 1093199598 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1093199598",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PHAM",
    "FirstName": "ELISE",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "DMD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "30 ROSY FINCH LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALISO VIEJO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92656-1814",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "949-357-3700",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "30 ROSY FINCH LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ALISO VIEJO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92656-1814",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "949-357-3700",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/14/2015",
    "LastUpdateDate": "07/14/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "122300000X",
        "TaxonomyName": "Dentist",
        "LicenseNumber": "64724",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.