Individual provider Active NPI

Tammy Ngoc Tran, DDS

  • General Practice Dentistry
  • Long Beach, CA
National Provider Identifier
1215068622
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
48560 Issued in CA
Practice address
990 Cherry Ave
Suite 104
Long Beach, CA 90813-5940
Phone
(562) 987-0626
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 48560 CA Primary

Addresses

Primary practice location

990 Cherry Ave
Suite 104
Long Beach, CA 90813-5940

Mailing address

1938 W Deerefield Rd
Santa Ana, CA 92704-7138
Phone (714) 241-7028

Other identifiers 1

IdentifierTypeStateIssuer
48560MedicaidCA

Other names 1

  • Tu Ngoc Tran Former name

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
I20160223002038 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3971808387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
48560CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Tammy N. Tran, D.D.S., Inc. General Practice PastSince Jul 24, 2022 Accepting new patients
Iraj Nouri DDS Inc. General Practice Past Accepting new patients

Organizations & group practices 2

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215068622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1938 W DEEREFIELD RD",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927047138",
            "telephone_number": "714-241-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 CHERRY AVE",
            "address_2": "SUITE 104",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908135940",
            "telephone_number": "562-987-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "TAMMY",
        "middle_name": "NGOC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TU",
            "last_name": "TRAN",
            "middle_name": "NGOC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.