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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

109 DENTAL GROUP, PROFESSIONAL CORPORATION
NPI 1447156245
Dentist - General Practice in Fountain Valley, CA

Active since October 17, 2026
10900 WARNER AVE STE 109, FOUNTAIN VALLEY, CA 92708(714) 963-5634 Get Directions Write a Review

NPPES record added: October 17, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About 109 Dental Group, Professional Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

109 DENTAL GROUP, PROFESSIONAL CORPORATION (NPI 1447156245), doing business as 109 Dental Group, is a healthcare organization registered as a general practice in Fountain Valley, California and active in the NPI registry since October 2026. The organization lists Thomas M Pham, Owner Dentist, as its authorized official.

NPPES Registry Identity

NPI1447156245
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business Name109 DENTAL GROUP, PROFESSIONAL CORPORATION
Location Address10900 WARNER AVE STE 109Fountain Valley, CA 92708-3846
Mailing Address400 Mobil Ave Ste A4Camarillo, CA 93010-6375 · (805) 484-3599
Phone(714) 963-5634
Organization SubpartNo
Authorized OfficialThomas M PhamOwner Dentist · (805) 484-3599
Enumeration DateOctober 17, 2026
NPPES CertifiedOctober 17, 2026
✔ NPI 1447156245 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
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.
10900 WARNER AVE STE 109, Fountain Valley, CA 92708
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Other Names 1

Doing Business As109 Dental Group

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ELY MARIANNE LUN-CHIAL DDS
Dentist
10900 WARNER AVE STE 109
FOUNTAIN VALLEY, CA 92708
Orange County (714) 963-5634

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 109 Dental Group, Professional Corporation's NPI number?

The NPI number for 109 Dental Group, Professional Corporation is 1447156245. It was assigned to this organization in the NPPES registry on October 17, 2026. The provider is doing business as 109 Dental Group.

Where is 109 Dental Group, Professional Corporation located?

109 Dental Group, Professional Corporation is located at 10900 Warner Ave Ste 109, Fountain Valley, CA 92708. The listed phone number is (714) 963-5634.

What is 109 Dental Group, Professional Corporation's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for 109 Dental Group, Professional Corporation was last updated on October 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.