Individual provider Active NPI

Tan Trinh, D.M.D.

  • Dentist
  • Hemet, CA
National Provider Identifier
1609243617
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS50836 Issued in CA
Practice address
4000 W Florida Ave
Hemet, CA 92545-5279
Phone
(951) 658-9980
NPI assigned
Aug 25, 2015
Last updated
Aug 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS50836 CA Primary

Addresses

Primary practice location

4000 W Florida Ave
Hemet, CA 92545-5279

Mailing address

23444 Mountain Breeze Dr
Murrieta, CA 92562-5033

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
I20170110000564 CA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8022399856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS50836CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Watanabe and Nosti Dental Corporation Past Accepting new patients

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": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1609243617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23444 MOUNTAIN BREEZE DR",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W FLORIDA AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925455279",
            "telephone_number": "951-658-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRINH",
        "first_name": "TAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS50836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.