Provider Demographics
NPI:1710418827
Name:BINH PHAN, D.D.S, INC.
Entity Type:Organization
Organization Name:BINH PHAN, D.D.S, INC.
Other - Org Name:CYPRESS DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BINH
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-841-5062
Mailing Address - Street 1:4971 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2805
Mailing Address - Country:US
Mailing Address - Phone:714-826-4640
Mailing Address - Fax:714-826-4672
Practice Address - Street 1:4971 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-2805
Practice Address - Country:US
Practice Address - Phone:714-826-4640
Practice Address - Fax:714-826-4672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty