Individual provider Active NPI

Khai Hung Tran, D.D.S.

  • General Practice Dentistry
  • Lakewood, CA
National Provider Identifier
1083798243
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
44550 Issued in CA
Practice address
5697 Woodruff Ave
Lakewood, CA 90713-1129
Phone
(562) 920-8880
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 44550 CA Primary

Addresses

Primary practice location

5697 Woodruff Ave
Lakewood, CA 90713-1129

Mailing address

5697 Woodruff Ave
Lakewood, CA 90713-1129
Phone (562) 920-8880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160613001458 CA Order and Referring Only - Other (Non-Physician) 9830489319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44550CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Khai H. Tran, D.D.S., Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1083798243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5697 WOODRUFF AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131129",
            "telephone_number": "562-920-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5697 WOODRUFF AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131129",
            "telephone_number": "562-920-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "KHAI",
        "middle_name": "HUNG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

Verify at the official NPI Registry.