Trang Khanh Mai, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010453A Issued in IN

Practice address

1637 Portage Ave
South Bend, IN 46616-1743

Phone

(574) 233-8444

Fax

(574) 233-8366

NPI assigned

Nov 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• South Bend Family Dentistry, P.C.

  • General Practice Dentistry
  • South Bend, IN
  • NPI 1841369535
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104995885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1637 PORTAGE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466161743",
            "telephone_number": "574-233-8444",
            "fax_number": "574-233-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1637 PORTAGE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466161743",
            "telephone_number": "574-233-8444",
            "fax_number": "574-233-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAI",
        "first_name": "TRANG",
        "middle_name": "KHANH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010453A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John H Mahon, M.D.
• Brianne Elizabeth Mahone
• Marion E. Mahone, MD
• Sara J Mahoney, MSN, RN, FNP-C
• Terrance P. Mahoney, D.D.S.
• Amina Maisoon
• John R Majewski, MD
• Suzanne Makielski, MS, OTR
• Making a Difference LLC
• Tracey Lynn Malesa-Wheaton, LCSW

• General Practice Dentistry in South Bend, IN
• Providers in South Bend, IN by specialty
• General Practice Dentistry in Indiana

• 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.

Verify at the official NPI Registry.