Individual provider Active NPI

Tran Bao To, D.D.S.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1265735591
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
59601 Issued in CA
Practice address
5877 S Vermont Ave
Los Angeles, CA 90044-3741
Phone
(323) 759-1523
NPI assigned
Dec 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 59601 CA Primary

Addresses

Primary practice location

5877 S Vermont Ave
Los Angeles, CA 90044-3741

Mailing address

8442 Tulipwood Cir
Westminster, CA 92683-6336

Other practice location 1

13505 Hawthorne Blvd
Hawthorne, CA 90250-5807
Phone (310) 970-0584

Other practice location 2

1112 W 6th St Ste 105
Corona, CA 92882-3137
Phone (951) 200-5553

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
I20151201002459 CA Order and Referring Only - DentistPractitioner - Dentist 0840590576

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59601CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
J Chun Dental Corp Dentist 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": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1265735591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8442 TULIPWOOD CIR",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5877 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900443741",
            "telephone_number": "323-759-1523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13505 Hawthorne Blvd",
            "address_purpose": "LOCATION",
            "city": "Hawthorne",
            "state": "CA",
            "postal_code": "902505807",
            "country_code": "US",
            "telephone_number": "310-970-0584",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1112 W 6th St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928823137",
            "country_code": "US",
            "telephone_number": "951-200-5553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TO",
        "first_name": "TRAN",
        "middle_name": "BAO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-08",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.