# DR. BENJAMIN PHAM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1922434562
- **Gender:** Man
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 056971-1 | NY | — |
| 1223P0221X | Pediatric Dentistry | 64392 | CA | — |
| 1223P0221X | Pediatric Dentistry | D10575 | OR | Yes |

## Other

- **Enumeration date:** 09/14/2013
- **Last updated:** 11/30/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 03818279 | — | NY |