DR. H. DERICK PHAN


Address: 11040 Bollinger Canyon Rd, Suite K, San Ramon, CA 94582-4959
Phone: 9256488588

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 11040 BOLLINGER CANYON RD
SUITE K
City SAN RAMON
State CA
Zip Code 94582-4959

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 1223X0400X
Grouping Dental Providers
Classification Dentist
Specialization Orthodontics and Dentofacial Orthopedics

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City SAN RAMON
Zip Code 94582

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Dataset Information

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.

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