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General NPI Number Information
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NPI Number | 1326241928
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Entity Type | Individual
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Provider Name | AIDAN N PHAN DDS, MD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2007
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 3443 RENNER RD STE 100
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City | PLANO
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State | TX
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Zip | 75074-0051
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Country | US
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Telephone | 214-572-8633
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Fax | 214-572-8638
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Provider Business Mailing Address
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Address Line | 3443 RENNER RD STE 100
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City | PLANO
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State | TX
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Zip | 75074-0051
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Country | US
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Telephone | 214-572-8633
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Fax | 214-572-8638
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 23584
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 23584
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License Number State | TX
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