Active NPI
An-Vinh Tran
- Dentist
- Marysville, WA
National Provider Identifier
1043008204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8236
- Practice address
- 17103 28TH Dr NE Ste 104
Marysville, WA 98271-4830 - Phone
- (360) 208-0492
- NPI assigned
- Apr 28, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DENT.DE.70135737 | WA | |
| Dentist | 122300000X | 8236 | NV | Primary |
Addresses
Primary practice location
17103 28TH Dr NE Ste 104
Marysville, WA 98271-4830
Mailing address
17103 28TH Dr NE Ste 104
Marysville, WA 98271-4830
Phone (360) 208-0492
Other practice location 1
4950 W Sahara Ave Ste 100
Las Vegas, NV 89146-3462
Phone (702) 680-1525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251009001442 | NV | Order and Referring Only - Dentist | 2769989383 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8236 | NV | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tang Sahara Modern Dentistry, PC | Current | Accepting new patients |
Locations
4950 W Sahara Ave
#100
Las Vegas, NV 89146
Phone (702) 680-1525
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Las Vegas, NV
- NPI 1124603832
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789430400000",
"number": "1043008204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17103 28TH DR NE STE 104",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982714830",
"telephone_number": "360-208-0492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17103 28TH DR NE STE 104",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982714830",
"telephone_number": "360-208-0492"
}
],
"practiceLocations": [
{
"address_1": "4950 W Sahara Ave Ste 100",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891463462",
"country_code": "US",
"telephone_number": "702-680-1525",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRAN",
"first_name": "AN-VINH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-04-28",
"last_updated": "2026-09-15",
"certification_date": "2026-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DENT.DE.70135737",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "8236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marysville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.