Mimi T Tran, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

100245 Issued in CA

Practice address

15706 Pomerado Rd Ste 205
Poway, CA 92064-2033

Phone

(858) 674-5954

NPI assigned

Aug 20, 2014

Last updated

Jun 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Erela Katz Rappaport DMD a Professional Corporation

  • General Practice Dentistry
  • Poway, CA
  • NPI 1427622489
  NPD
• Charles U. Basso DDS Inc

  dba Grand Dentistry

  • General Practice Dentistry
  • Escondido, CA
  • NPI 1497389373
  NPD (past)
• Kathrina Agatep DDS, PC

  dba Dental Design SD

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1306388418
  NPD (past)
• Leslie K Bonar DDS Apc & Charles U Basso DDS Apc PTR

  • General Practice Dentistry
  • Escondido, CA
  • NPI 1487709572
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1053710699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15706 POMERADO RD STE 205",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642033",
            "telephone_number": "858-674-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15706 POMERADO RD STE 205",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642033",
            "telephone_number": "858-674-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "MIMI",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS100245",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-024310",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Elizabeth Totton
• Brianna Tovalin
• Juliann Tran, PHARM.D.
• Kenny Tuan Tran, DDS, MSD
• Lily Ly Tran, PH.D.
• Nancy Tran
• Roger Trong Tran, DDS
• Thuy Thi Tran, PHARM.D.
• Joel Traut, MD
• Robert S Trautman, RPH

• Dentist in Poway, CA
• Providers in Poway, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.