Active NPI
Johnathan H Tran, D.D.S
- Dentist
- San Marcos, CA
National Provider Identifier
1306079413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 58702
- Practice address
- 150 Valpreda Rd
San Marcos, CA 92069-2973 - Phone
- (760) 736-6780
- NPI assigned
- Aug 24, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 58702 | CA | Primary |
Addresses
Primary practice location
150 Valpreda Rd
San Marcos, CA 92069-2973
Mailing address
150 Valpreda Rd
San Marcos, CA 92069-2973
Phone (760) 736-6780
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170119001420 | CA | Order and Referring Only - Dentist | 3173805561 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- jtran617112@direct.ochin.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669939200000",
"number": "1306079413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 VALPREDA RD",
"city": "SAN MARCOS",
"state": "CA",
"postal_code": "920692973",
"telephone_number": "760-736-6780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 VALPREDA RD",
"city": "SAN MARCOS",
"state": "CA",
"postal_code": "920692973",
"telephone_number": "760-736-6780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAN",
"first_name": "JOHNATHAN",
"middle_name": "H",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-24",
"last_updated": "2022-12-02",
"certification_date": "2022-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "58702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Marcos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.