DR. H. DERICK PHAN (NPI# 1609075910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609075910 |
Entity Type | Individual |
Full Name | DR. H. DERICK PHAN |
Credential | D.D.S., C.A.G.S. |
Practice Address |
11040 Bollinger Canyon Rd Suite K San Ramon CA 94582-4959 |
Practice Telephone | 9256488588 |
Practice Fax Number | 9256488008 |
Mailing Telephone | 9256488588 |
Mailing Fax Number | 9256488008 |
Enumeration Date | 2007-07-16 |
Last Update Date | 2008-07-29 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
49186 | CA | Dental Providers |
N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
D6446 | AZ | Dental Providers |
Street Address |
11040 BOLLINGER CANYON RD SUITE K |
City | SAN RAMON |
State | CA |
Zip Code | 94582-4959 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093206815 | Henry Ma | Dentist | 11040 Bollinger Canyon Rd, San Ramon, CA 94582-4969 | 2018-05-29 |
1851811822 | Revelcare LLC | Technician, Pathology | 11040 Bollinger Canyon Rd, Ste 839, San Ramon, CA 94582 | 2017-06-21 |
1275856817 | Jenny Yoo | Dentist | 11040 Bollinger Canyon Rd, Suite I, San Ramon, CA 94582-4969 | 2010-03-10 |
1215160106 | Tiffany Louie Hong | Dentist | 11040 Bollinger Canyon Rd, Suite I, San Ramon, CA 94582-4969 | 2009-08-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184252710 | John Paul Yap | Student in an Organized Health Care Education/Training Program | 741 Roseum Ct, San Ramon, CA 94582 | 2020-03-30 |
1740762103 | Gilan Mansour | Pharmacist | 7108 Watsonia Dr, San Ramon, CA 94582 | 2018-09-03 |
1235635624 | Justin Michael Chan | Pharmacist | 11440 Windemere Parkway, San Ramon, CA 94582 | 2018-04-04 |
1033643317 | Ebony Shaunte Berry | Behavior Technician | 3201 Crestfield Dr, San Ramon, CA 94582 | 2017-04-13 |
1558729202 | Hoa Trang | Pharmacist | 2053 Poinsettia Street, San Ramon, CA 94582 | 2016-02-09 |
1922364652 | Aruna Somani | Internal Medicine | 6400 Main Branch Road, San Ramon, CA 94582 | 2012-04-06 |
1790061364 | Darren Dong-shung Gae | Pharmacist | 11440 Windemere Pkwy, San Ramon, CA 94582 | 2011-10-27 |
1134457112 | Azmeena Amir Hashem | Nurse Practitioner | 3085 Lakemont Dr Unit 3, San Ramon, CA 94582 | 2009-12-02 |
1619985892 | Rashpal S. Deol | Dentist | 500 Bollinger Canyon Way Ste 8.5, San Ramon, CA 94582 | 2006-08-04 |
1023553542 | Alan Phan | Pharmacist | 11440 Windemere Pkwy, San Ramon, CA 94582 | 2016-12-20 |
Find all providers in zip 94582 |
Taxonomy Code | 1223X0400X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Orthodontics and Dentofacial Orthopedics |
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023202298 | Gary William Greer | Dentist | 2817 Crow Canyon Rd Ste 200, San Ramon, CA 94583-1639 | 2007-08-30 |
1558486514 | Jerry H. Watanabe | Dentist | 9301 Fircrest Ln Ste 1, San Ramon, CA 94583-3960 | 2007-03-20 |
1922185461 | Barbara G. Yee, Dds, Ms, Inc | Dentist | 3130 Crow Canyon Rd Ste B, San Ramon, CA 94583-1365 | 2006-11-01 |
1962580936 | Dr. Sandy Bigman | Dentist | 525 Bollinger Canyon Way Ste 102, San Ramon, CA 94582-4935 | 2006-11-01 |
1821404179 | Arash Abolfazlian, Dds, Msd, Inc. | Dentist | 111 Deerwood Rd, Suite 390, San Ramon, CA 94583-4409 | 2014-07-08 |
1780011106 | Arash Abolfazlian | Dentist | 111 Deerwood Rd, San Ramon, CA 94583-4409 | 2013-09-30 |
1275856817 | Jenny Yoo | Dentist | 11040 Bollinger Canyon Rd, Suite I, San Ramon, CA 94582-4969 | 2010-03-10 |
1215160106 | Tiffany Louie Hong | Dentist | 11040 Bollinger Canyon Rd, Suite I, San Ramon, CA 94582-4969 | 2009-08-26 |
1225225071 | Margarita Monica Lachica | Dentist | 9301 Fircrest Ln, Suite 5, San Ramon, CA 94583-3960 | 2007-09-25 |
1174727648 | Harry Robert Van Den Berg | Dentist | 1501 Bollinger Canyon Rd, Suite A, San Ramon, CA 94583-1758 | 2007-06-11 |
Find all providers in SAN RAMON |
Please comment or provide details below to improve the information on DR. H. DERICK PHAN.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.