KELLY PHAM (NPI# 1841734126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841734126 |
| Entity Type | Individual |
| Full Name | KELLY PHAM |
| Credential | RDH |
| Practice Address |
1211 Meridian Ave San Jose CA 95125-5210 |
| Practice Telephone | 4084453400 |
| Mailing Telephone | 4084453400 |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2016-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 24883 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DENTAL HYGIENIST | 124Q00000X | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508300799 | Kelly Kim Dung Pham | Pharmacist | 6620 Summertrail Pl, Highland, CA 92346-6063 | 2016-12-07 |
| 1497136535 | Kelly Pham | Optometrist | 10934 Pebble Run Dr, Silver Spring, MD 20902-3683 | 2015-06-15 |
| 1649730557 | Kelly Pham | Student in an Organized Health Care Education/Training Program | 701 W Pratt St Rm 474, Baltimore, MD 21201-1023 | 2019-03-25 |
| 1932696457 | Kelly Pham | Pharmacist | 3151 University Ave, San Diego, CA 92104-2039 | 2018-04-19 |
| 1295010072 | Kelly Pham | Pharmacist | 3099 Bethel Rd Se, Port Orchard, WA 98366-2432 | 2011-10-12 |
| 1114231669 | Kelly T Pham | Student in an Organized Health Care Education/Training Program | 2400 Moorpark Ave Ste 300, San Jose, CA 95128-2680 | 2010-07-27 |
| 1417274689 | Kelly Loraine Dauer Pham | Physical Medicine & Rehabilitation | 4800 Sand Point Way Ne, Department of Pediatric Rehabilitation Medicine, Seattle, WA 98105-3901 | 2010-04-28 |
| 1588641948 | Kelly H Pham | Radiology | 6600 Bruceville Rd, Sacramento, CA 95823-4671 | 2005-12-28 |
| Street Address |
1211 MERIDIAN AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95125-5210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720153133 | Scv Pharmaceuticals Inc. | Pharmacy | 1211 Meridian Ave, San Jose, CA 95125-5210 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245431 | Carmen J. Frank | Marriage & Family Therapist | 913 Willow St., Suite 103, San Jose, CA 95125 | 2020-08-12 |
| 1376197848 | Mariam Samir Abadir | Dentist | 1670 Westwood Dr. Suite K, San Jose, CA 95125 | 2019-08-01 |
| 1750870747 | Gertrud Stojancic | Massage Therapist | 3315 Almaden Expressway, # 27/29, San Jose, CA 95125 | 2018-05-04 |
| 1659809259 | Edward Escoto | Assistant Behavior Analyst | 2075 Lincoln Ave Ste D, San Jose, CA 95125 | 2017-05-25 |
| 1104288422 | Kristin Ann Dessau | Counselor | 1261 Lincoln Avenue, Suite 202, San Jose, CA 95125 | 2016-03-25 |
| 1275964488 | Indian Health Center of Santa Clara Valley | Clinic/Center | 1685 Westwood Dr Ste 1, San Jose, CA 95125 | 2013-12-13 |
| 1598042905 | Walgreens | Exclusive Provider Organization | 2585 Almaden Road, San Jose, CA 95125 | 2011-11-14 |
| 1881981488 | Kevin Jia-chian Yen | Dentist | 1660 Willow St Ste 5, San Jose, CA 95125 | 2011-07-02 |
| 1699093724 | Lokahi Acupuncture, Inc. | Acupuncturist | 1688 Willow Street, Suite B, San Jose, CA 95125 | 2010-05-13 |
| 1538482468 | Mark Lucius Yoslow | Psychologist | 970 Minnesota Avenue, San Jose, CA 95125 | 2010-03-06 |
| Find all providers in zip 95125 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234047 | Maryann Detar | Dental Hygienist | 3154 Alum Rock Ave, San Jose, CA 95127-2903 | 2020-10-29 |
| 1669900924 | Truc Thanh Tran | Dental Hygienist | 2380 Montpelier Dr Ste 200, San Jose, CA 95116-1620 | 2017-05-31 |
| 1013307651 | Kevin Dizon | Dental Hygienist | 6071 Sunstone Drive, San Jose, CA 95123 | 2015-02-04 |
| 1457781320 | Benjamin Mendoza | Dental Hygienist | 2195 Monterey Hwy Ste 30, San Jose, CA 95125-1069 | 2013-11-13 |
| 1003258559 | Phoebe Chenh | Dental Hygienist | 480 Caprice Dr, San Jose, CA 95123-5943 | 2013-07-25 |
| 1053658476 | Debra Barker Kanagaki | Dental Hygienist | 5542 Monterey Hwy # 336, San Jose, CA 95138-1529 | 2013-01-04 |
| 1235489626 | Emerlyn Sangha | Dental Hygienist | 1878 Oakton Court, San Jose, CA 95148 | 2012-09-13 |
| 1417237637 | Deborah Anne Dowrie | Dental Hygienist | 3567 Kilo Ave, San Jose, CA 95124-3143 | 2011-08-18 |
| 1366748683 | Barbara Jeanne Walters | Dental Hygienist | 887 Redbird Dr, San Jose, CA 95125-2824 | 2011-02-03 |
| 1417279928 | Ema Bayani | Dental Hygienist | 6141 Royal Acorn Pl, San Jose, CA 95120-2756 | 2010-02-24 |
| Find all providers in SAN JOSE | ||||
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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.