Phuong Tran

Primary specialty

DentistTaxonomy code 122300000X

License

7073 Issued in OK

Practice address

7223 Mississippi Ave BLDG 1561
Ft. Polk, LA 71459-5110

Phone

(337) 531-2327

NPI assigned

Aug 1, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1194203166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6712 NW 112TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731622978",
            "telephone_number": "405-887-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7223 MISSISSIPPI AVE BLDG 1561",
            "city": "FT. POLK",
            "state": "LA",
            "postal_code": "714595110",
            "telephone_number": "337-531-2327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5615 Hood St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292075109",
            "country_code": "US",
            "telephone_number": "803-751-3255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "PHUONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2023-04-04",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "7073",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "7073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malcolm Edward Thornton, D.M.D.
• Laurel Ashlin Thurston, MD
• Gerard Tiffault, MD
• Adrian Yvette Todd, LCSW
• Douglas Tortella, CRNA
• Carolyn Evodney Turner-Walter, RN
• Mandy Ulery, LPC
• Jerome Clement Valenta Jr., M.D.
• Jerardy Ivan Velasquez-Bravo
• Michelle Marie Kruse Vincent, AU.D.

• Dentist in Ft. Polk, LA
• Providers in Ft. Polk, LA by specialty
• Dentist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.