Individual provider Active NPI

Joanna Rose Tran, DDS

  • General Practice Dentistry
  • Monticello, MN
National Provider Identifier
1124555636
Registry record updated May 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D13807 Issued in MN
Practice address
9281 Cedar St
Monticello, MN 55362-4507
Phone
(612) 361-5436
NPI assigned
May 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2017

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 D13807 MN Primary

Addresses

Primary practice location

9281 Cedar St
Monticello, MN 55362-4507

Mailing address

11084 Branching Horn
Eden Prairie, MN 55347-4923
Phone (612) 859-3306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20170815000032 MN Order and Referring Only - DentistPractitioner - Dentist 9133491962

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D13807MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Monticello Dentistry PLLC General Practice 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": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494806400000",
    "number": "1124555636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11084 BRANCHING HORN",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553474923",
            "telephone_number": "612-859-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9281 CEDAR ST",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553624507",
            "telephone_number": "612-361-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "JOANNA",
        "middle_name": "ROSE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-15",
        "last_updated": "2017-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, MN

Sources for this page

Verify at the official NPI Registry.