28 Smile, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

28 SMILE, LLC

Practice address

11403 Barker Cypress Rd Ste 1300
Cypress, TX 77433-5425

Phone

(281) 721-9575

Fax

(281) 721-9594

NPI assigned

Feb 14, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Peter Tran, DMDNPI 1619424561

Title

Doctor/Owner

Phone

(281) 721-9575

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Alder Trails Dental Doing business as

Practitioners 1

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

• Peter Tran, DMD

  • Dentist
  • Cypress, TX
  • NPI 1619424561
  NPD Authorized official

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1417413451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11403 BARKER CYPRESS RD STE 1300",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774335425",
            "telephone_number": "281-721-9575",
            "fax_number": "281-721-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11403 BARKER CYPRESS RD STE 1300",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774335425",
            "telephone_number": "281-721-9575",
            "fax_number": "281-721-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "28 SMILE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "281-721-9575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3735631",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1619424561",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alder Trails Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alder Trails Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.