Active NPI
Trung Dinh Tran, DMD
- General Practice Dentistry
- Elmira, NY
National Provider Identifier
1104904218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 48773
- Practice address
- 1141 Broadway St
Suite #5
Elmira, NY 14904-2542 - Phone
- (607) 732-2555
- Fax
- (607) 732-4447
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 48773 | NY | Primary |
Addresses
Primary practice location
1141 Broadway St
Suite #5
Elmira, NY 14904-2542
Mailing address
1141 Broadway St
Suite #5
Elmira, NY 14904-2542
Phone (607) 732-2555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02264253 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48773 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104904218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1141 BROADWAY ST",
"address_2": "SUITE #5",
"city": "ELMIRA",
"state": "NY",
"postal_code": "149042542",
"telephone_number": "607-732-2555",
"fax_number": "607-732-4447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1141 BROADWAY ST",
"address_2": "SUITE #5",
"city": "ELMIRA",
"state": "NY",
"postal_code": "149042542",
"telephone_number": "607-732-2555",
"fax_number": "607-732-4447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAN",
"first_name": "TRUNG",
"middle_name": "DINH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "48773",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02264253",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elmira, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.