Stacy Mai Pham, DDS
Stacy Mai Pham is a Dentist provider (Dentist) practicing in Riverside, CA, registered in the NPPES registry with NPI 1063420255 since 2006. The credential DDS stands for Doctor of Dental Surgery.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1063420255 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Stacy Mai Pham |
| Credential | DDS |
| Sex | Female |
| Practice address | 4000 TYLER ST, Riverside, CA, 92503 |
| Phone | 9516874155 |
| Fax | 9516877448 |
| Enumeration date | 2006-08-03 |
| Last updated in NPPES | 2020-01-27 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 122300000X | Dentist | Primary | 39461 | CA |
DDS — Doctor of Dental Surgery: A licensed dentist; DDS and DMD are equivalent dental degrees. About the DDS credential
Copy-ready billing details
Provider: Stacy Pham, DDS NPI: 1063420255 Taxonomy: 122300000X (Dentist) Address: 4000 TYLER ST, Riverside, CA, 92503
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1588778971 | Charles Jansen | Individual | Optometrist | Riverside, CA |
| 1821143744 | Michael Hensley | Individual | Optometrist | Riverside, CA |
| 1114053824 | Today Dental Office | Organization | Dental Clinic/Center | Riverside, CA |
| 1336342237 | Charles A Jansen, Od, Inc | Organization | Optometrist | Riverside, CA |
| 1174938963 | Bryan Mirone | Individual | Optometrist | Riverside, CA |
| 1851928063 | Bryan J Mirone Optometric Inc | Organization | Optometrist | Riverside, CA |
Verify this record
Cross-check NPI 1063420255 against the authoritative CMS record: view Stacy Mai Pham on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-01-27.