NPIMap

Organization Active NPI

KT Dental LLC

  • Dental Clinic/Center
  • Broomall, PA
National Provider Identifier
1235615964
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
KT DENTAL LLC
Practice address
2002 Sproul Rd Ste 100
Broomall, PA 19008-3510
Phone
(610) 325-1670
NPI assigned
Jul 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Authorized official

Name
Dr. Kim L Tran, DMD
Title
Dentist
Phone
(610) 325-1670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2002 Sproul Rd Ste 100
Broomall, PA 19008-3510

Mailing address

2002 Sproul Rd Ste 100
Broomall, PA 19008-3510
Phone (610) 325-1670

Other names 1

  • INNOVATIVE DENTAL HEALTH Doing business as

National Provider Directory

National Provider Directory

Locations

2002 Sproul Rd
Ste 100
Broomall, PA 19008
Phone (610) 325-1670

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1235615964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 SPROUL RD STE 100",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083510",
            "telephone_number": "610-325-1670",
            "fax_number": "610-325-1675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 SPROUL RD STE 100",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083510",
            "telephone_number": "610-325-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KT DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-16",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "610-325-1670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INNOVATIVE DENTAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Broomall, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.