Provider Demographics
NPI:1154305928
Name:PHAM, GIANG BINH (DDS)
Entity Type:Individual
Prefix:
First Name:GIANG
Middle Name:BINH
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 1:4601 N CLASSEN BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-4815
Mailing Address - Country:US
Mailing Address - Phone:405-840-9966
Mailing Address - Fax:405-860-9966
Practice Address - Street 1:4601 N CLASSEN BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-4815
Practice Address - Country:US
Practice Address - Phone:405-840-9966
Practice Address - Fax:405-860-9966
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4328122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist