Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1518658079 Individual Practitioner Male Practitioner

Nicky Pham

Dentist - General Practice • Moore, OK

Professional Overview & Biography Verified Profile Summary

Nicky Pham is a registered healthcare professional specializing in Dentist - General Practice in Moore, OK. Practice services are available at 811 SW 19TH ST STE A under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

811 Sw 19th St Ste A

Moore, OK 731602890

Telephone 4057035161
Associated Practice Facility / Clinic
🏢 Summer Dental Moore Pllc Facility NPI 1578056065

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Moore, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.8 Yrs
Regional Practice Density
20 Specialists

Practicing in Moore, OK (1496 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-05-16
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OK 7750

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1053101089
NPI 1265055917

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active May 16, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location May 16, 2023

Registered at 811 SW 19TH ST STE A, MOORE, OK 731602890 (Tel: 4057035161)

📍
Updated Business Mailing Address May 16, 2023

Registered at 400 RIVERWALK TER STE 250, JENKS, OK 740375619

👤
Provider Name / Credentials Updated May 16, 2023

Recorded as NICKY PHAM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 16, 2023

Dentist (License #7750 in OK)

🟢
Initial NPI Registration & Enumeration May 16, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1518658079
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 16, 2023
Last Update: May 16, 2023
Sole Proprietor: No

Mailing Address

400 Riverwalk Ter Ste 250

Jenks, OK 740375619

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.