Phong Tran, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45624 Issued in CA

Practice address

4500 Rosemead Blvd Ste a
Pico Rivera, CA 90660-2081

Phone

(562) 692-9196

NPI assigned

Nov 17, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Phong T. Tran DDS, Inc

  • General Practice Dentistry
  • Pico Rivera, CA
  • NPI 1417171646
  NPD (past) Authorized official

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632528000000",
    "number": "1467994798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4522 1/2 ROSEMEAD BLVD",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602057",
            "telephone_number": "562-692-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 ROSEMEAD BLVD STE A",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602081",
            "telephone_number": "562-692-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "PHONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-17",
        "last_updated": "2021-09-25",
        "certification_date": "2021-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eydan Torres
• Teresa Orejel Torres, RN
• Alejandro Toruno
• Ken Tran
• Minou P. Tran, M.D.
• Robert G Tran, PHARM D
• Daniel Samuel Trejo, MSW
• Nicole Fernanda Trejo, ASW
• Oscar Ramiro Trigoso, DDS
• Bach Truong, PHARM.D.

• General Practice Dentistry in Pico Rivera, CA
• Providers in Pico Rivera, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.