KIM KHUE THI PHUNG (NPI# 1679627665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679627665 |
| Entity Type | Individual |
| Full Name | KIM KHUE THI PHUNG |
| Credential | D.D.S |
| Practice Address |
220 E 10th St #k Gilroy CA 95020-6580 |
| Practice Telephone | 4088429439 |
| Practice Fax Number | 4088429475 |
| Mailing Telephone | 4088429439 |
| Mailing Fax Number | 4088429475 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
45756 | CA | Dental Providers |
| Street Address |
220 E 10TH ST #K |
| City | GILROY |
| State | CA |
| Zip Code | 95020-6580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376158105 | Benjamin Liupaogo | Case Manager/Care Coordinator | Rebekah Children's Services, 290 Ioof Ave, Gilroy, CA 95020 | 2020-09-09 |
| 1205457330 | Ethel Rostran | Counselor | 290 I00f Ave., Gilroy, CA 95020 | 2020-04-29 |
| 1407498868 | Mehak Saini | Behavior Technician | 9360 Noname Uno, Gilroy, CA 95020 | 2019-10-16 |
| 1629622899 | Bruce Daniel Pirl | Counselor | 290 Ioof Rebekah Children Ave, 290 Ioof Avenue-phoenix School, Gilroy, CA 95020 | 2019-07-26 |
| 1932752490 | Eamon F. Burke | Counselor | Rebekah Children Services, 290 Ioof Ave., Gilroy, CA 95020 | 2019-07-23 |
| 1578116232 | Jose Enrique Cruz | Behavior Technician | 9360 Noname Uno #130, Gilroy, CA 95020 | 2019-07-22 |
| 1558925560 | Mauricio Hazael Procopio | Behavioral Analyst | 9360 Noname Uno Suite 130, Gilroy, CA 95020 | 2019-04-24 |
| 1689138893 | Gabriela Mendoza | Behavioral Analyst | 9395 Kern Ave, Gilroy, CA 95020 | 2019-01-22 |
| 1972082782 | Andrea Gloria Blanton | Social Worker | Rebekah Children's Services, 290 100f Ave, Gilroy, CA 95020 | 2018-08-13 |
| 1407334626 | Katrina Davina Aguilera | Case Manager/Care Coordinator | 290 Loof Ave., Gilroy, CA 95020 | 2018-07-31 |
| Find all providers in zip 95020 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760977276 | Rupinder Purewal Dds, Inc. | Dentist | 6974 Automall Pkwy, Gilroy, CA 95020-7135 | 2018-06-27 |
| 1477078665 | Ivette M San Juan | Dentist | 1495 Mantelli Dr, Gilroy, CA 95020-3772 | 2017-08-08 |
| 1578813283 | Haejin Kim | Dentist | 9460 No Name Uno Dr, Gilroy, CA 95020 | 2012-09-11 |
| 1124257001 | Kinberly Antrim | Dentist | 7880 Wren Ave Ste B125, Gilroy, CA 95020-7801 | 2009-07-13 |
| 1114145265 | Efrain Arturo Montana | Dentist | 7880 Wren Ave Ste D145, Gilroy, CA 95020-7802 | 2007-04-23 |
| 1417089541 | John Barron Perez | Dentist | 7880 Wren Ave Ste F162, Gilroy, CA 95020-7802 | 2007-03-12 |
| 1528197142 | Van B Pham | Dentist | 7210 Camino Arroyo, Suite 106, Gilroy, CA 95020-7311 | 2007-03-02 |
| 1750418356 | Jeffrey Ross Laveroni | Dentist | 1335 1st St, Gilroy, CA 95020-4738 | 2007-02-28 |
| 1033255443 | Kourosh Bruce Sarhaddi | Dentist | 7880 Wren Ave Ste E155, Gilroy, CA 95020-7802 | 2007-01-30 |
| 1427124528 | Yinghui Pan | Dentist | 8060 Santa Teresa Blvd, #120, Gilroy, CA 95020-3867 | 2006-11-28 |
| Find all providers in GILROY | ||||
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| 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.