Individual provider Active NPI

Quan Anh Tran, D.M.D

  • General Practice Dentistry
  • Albuquerque, NM
National Provider Identifier
1306043922
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4687 Issued in NM
Practice address
1628 Alameda Blvd NW
Albuquerque, NM 87114-8807
Phone
(505) 200-9399
NPI assigned
Jun 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 009725 CT
General Practice Dentistry 1223G0001X 4687 NM Primary

Addresses

Primary practice location

1628 Alameda Blvd NW
Albuquerque, NM 87114-8807

Mailing address

1628 Alameda Blvd NW
Albuquerque, NM 87114-8807
Phone (505) 200-9399

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
009725CTMDGeneral Practice Dentistry
4687NMMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kneeland Dental Care, LLC General Practice Current Accepting new patients

Locations

1628 Alameda Blvd NW
Albuquerque, NM 87114
Phone (505) 200-9399

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1306043922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 ALAMEDA BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871148807",
            "telephone_number": "505-200-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 ALAMEDA BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871148807",
            "telephone_number": "505-200-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "QUAN ANH",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009725",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "4687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.