Theodore Tran, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D011795 Issued in AZ

Practice address

15317 W Bell Rd Ste 108
Surprise, AZ 85374-3901

Phone

(877) 809-5092

Fax

(623) 214-5231

NPI assigned

Jun 6, 2023

Last updated

Sep 29, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Salt River Pima-Maricopa Indian Community

  dba Salt River Integrated Health Care

  • Community Health Clinic/Center
  • Scottsdale, AZ
  • NPI 1942668991

  TX

  Medicare reassignment NPD
• Salt River Pima-Maricopa Indian Community

  dba Department of Health and Human Services

  • Community Health Clinic/Center
  • Scottsdale, AZ
  • NPI 1538583125
  NPD
• Adelante Healthcare Inc

  • Federally Qualified Health Center (FQHC)
  • Surprise, AZ
  • NPI 1407132673
  NPD (past)
• Adelante Healthcare, Inc

  dba Adelante Healthcare-Roosevelt

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1215734124
  NPD (past)

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1497449037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 N CENTRAL AVE STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122808",
            "telephone_number": "623-583-3001",
            "fax_number": "623-583-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15317 W BELL RD STE 108",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743901",
            "telephone_number": "877-809-5092",
            "fax_number": "623-214-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011795",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nakiya Sue Toth
• Courtney Town
• TP Dentistry
• Andy T Tran, MD
• Karen Tran
• Tranquility House LLC
• Aubrie Taylor Traverso
• Travis S Jensen DPM PC
• Elana Trejo
• Denise A Trichilo, MA, LAC

• Dentist in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.

Verify at the official NPI Registry.