Individual provider Active NPI

Brandee Tran Ma, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1114642063
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
108161 Issued in CA
Practice address
1751 Colorado Blvd # 347
Los Angeles, CA 90041-1348
Phone
(415) 218-5486
NPI assigned
Oct 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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 108161 CA Primary

Addresses

Primary practice location

1751 Colorado Blvd # 347
Los Angeles, CA 90041-1348

Mailing address

1751 Colorado Blvd # 347
Los Angeles, CA 90041-1348
Phone (415) 218-5486

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230510002746 CA Order and Referring Only - DentistPractitioner - Dentist 4688030067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1114642063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 COLORADO BLVD # 347",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411348",
            "telephone_number": "415-218-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 COLORADO BLVD # 347",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411348",
            "telephone_number": "415-218-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "BRANDEE",
        "middle_name": "TRAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2023-06-12",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.