109 Dental Group, Professional Corporation
NPI 1447156245ActiveOrganization· Dentist, General Practice· Fountain Valley, CA
Dentist, General Practice in Fountain Valley, California, registered in NPPES in October 2026. The authorized official on file is Thomas M. Pham, DMD, Owner Dentist.
Overview
| NPI | 1447156245 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 17, 2026 |
| Last updated in NPPES | Oct 17, 2026 |
| Certified by provider | Oct 17, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 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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