Active NPI
Kenny Hung Tran, DMD
- General Practice Dentistry
- Gilbert, AZ
National Provider Identifier
1124868385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D012142
- Practice address
- 4365 E Pecos Rd Ste 127
Gilbert, AZ 85295-8052 - Phone
- (480) 331-4955
- NPI assigned
- May 27, 2024
- Sex
- Male
- Sole proprietor
- No
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 | D012142 | AZ | Primary |
Addresses
Primary practice location
4365 E Pecos Rd Ste 127
Gilbert, AZ 85295-8052
Mailing address
18111 S 3Rd St
Fountain Valley, CA 92708-4424
Phone (714) 230-9519
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 |
|---|---|---|---|
| D012142 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716768000000",
"number": "1124868385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18111 S 3RD ST",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927084424",
"telephone_number": "714-230-9519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4365 E PECOS RD STE 127",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852958052",
"telephone_number": "480-331-4955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAN",
"first_name": "KENNY",
"middle_name": "HUNG",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-27",
"last_updated": "2024-05-27",
"certification_date": "2024-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D012142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.