Individual provider Active NPI

Christine Tran, DDS, MS

  • Periodontics
  • Newport Beach, CA
National Provider Identifier
1588298939
Registry record updated Jul 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
104614 Issued in CA
Practice address
400 Newport Center Dr Ste 306
Newport Beach, CA 92660-7635
Phone
(949) 644-0680
NPI assigned
Feb 25, 2020
Last updated
Jul 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 104614 CA
Periodontics 1223P0300X 104614 CA Primary

Addresses

Primary practice location

400 Newport Center Dr Ste 306
Newport Beach, CA 92660-7635

Mailing address

36 Camino Katia
San Clemente, CA 92672-9420
Phone (562) 508-7845

Other practice location 1

36 Camino Katia
San Clemente, CA 92672-9420
Phone (714) 584-4485

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230711004243 CA Order and Referring Only - DentistPractitioner - Dentist 8325407109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
104614CAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688428800000",
    "number": "1588298939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 CAMINO KATIA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926729420",
            "telephone_number": "562-508-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NEWPORT CENTER DR STE 306",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607635",
            "telephone_number": "949-644-0680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36 Camino Katia",
            "address_purpose": "LOCATION",
            "city": "San Clemente",
            "state": "CA",
            "postal_code": "926729420",
            "country_code": "US",
            "telephone_number": "714-584-4485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2023-07-04",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "104614",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "104614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.