Pham, Ian
Pham, Ian is an sole proprietor health care provider with primary practice located at 18791 Sw Boones Ferry Rd Suite 3, Tualatin OR 97062-8412. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Pham, Ian can be contacted via phone (503) 692-6552.Contact Information
Primary practice address
18791 Sw Boones Ferry Rd Suite 3
Tualatin OR 97062-8412
Phone: (503) 692-6552
Fax: (503) 692-1452
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D7808 | Oregon |
Profile Details
| NPI number | 1710947494 |
|---|---|
| LBN Legal business name | Pham, Ian |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 25th, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710947494 | NPPES |
| Oregon | Other | D7808 | STATE LICENSE |
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