Provider Demographics
NPI:1083610067
Name:PHAM, LANCHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:LANCHI
Middle Name:
Last Name:PHAM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 SILVER CREEK RD
Mailing Address - Street 2:STE 146
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1789
Mailing Address - Country:US
Mailing Address - Phone:408-238-7900
Mailing Address - Fax:408-238-7909
Practice Address - Street 1:3005 SILVER CREEK RD
Practice Address - Street 2:STE 146
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1789
Practice Address - Country:US
Practice Address - Phone:408-238-7900
Practice Address - Fax:408-238-7909
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA469261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice