Mary R Pham DDS Dental Corporation
NPI 1194491738ActiveOrganization· Dentist, Pediatric Dentistry· Lake Forest, CA
Dentist, Pediatric Dentistry in Lake Forest, California, registered in NPPES in August 2021. The authorized official on file is Mary Regina Pham, D.D.S, Ceo/Pediatric Dentist.
Overview
| NPI | 1194491738 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 23, 2021 |
| Last updated in NPPES | Aug 25, 2021 |
| Certified by provider | Aug 25, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Pediatric Dentistry Primary | 1223P0221X | — | — |
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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