Individual provider Active NPI

Lisa Nguyen Tran, DDS MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Orange, CA
National Provider Identifier
1588980767
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
143261 Issued in CA
Practice address
436 S Glassell St
Orange, CA 92866-1906
Phone
(714) 998-7450
Fax
(714) 998-2857
NPI assigned
Apr 14, 2010
Last updated
Apr 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 1797 CA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 60421 CA
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 143261 CA Primary

Addresses

Primary practice location

436 S Glassell St
Orange, CA 92866-1906

Mailing address

436 S Glassell St
Orange, CA 92866-1906
Phone (714) 998-7450

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161019000926 CA Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 6204124522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
Emory University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford L Ratner DDS and Monty C Wilson DDS IncGroup PAC ID 1850479858, 2 clinicians

Practice addresses (Care Compare)

1200 N Tustin Ave
Suite 108
Santa Ana, CA 92705-3555
Phone (714) 835-7771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
143261CAMDOral & Maxillofacial Surgery (D.M.D.)
1797CAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford L. Ratner DDS and Monty C.Wilson DDS Inc. Oral and Maxillofacial Surgery CurrentSince Sep 3, 2016 Accepting new patients

Locations

1122 E Lincoln Ave
Ste 105
Orange, CA 92865
Phone (714) 987-9880

436 S Glassell St
Orange, CA 92866
Phone (714) 633-6060

1200 N Tustin Ave
Ste 108
Santa Ana, CA 92705
Phone (714) 835-7771

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1588980767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 S GLASSELL ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661906",
            "telephone_number": "714-998-7450",
            "fax_number": "714-998-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 S GLASSELL ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661906",
            "telephone_number": "714-998-7450",
            "fax_number": "714-998-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "LISA",
        "middle_name": "NGUYEN",
        "credential": "DDS MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "1797",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "60421",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "143261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.