Individual provider Active NPI

Trang Minh Doan, DDS

  • Dentist
  • Moscow, ID
National Provider Identifier
1659825073
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D-4877 Issued in ID
Practice address
803 S Main St Ste 120
Moscow, ID 83843-2695
Phone
(208) 848-8300
Fax
(509) 444-7806
NPI assigned
Aug 15, 2016
Last updated
Dec 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D-4877 ID Primary

Addresses

Primary practice location

803 S Main St Ste 120
Moscow, ID 83843-2695

Mailing address

611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20180220002421 ID Order and Referring Only - DentistPractitioner - Dentist 3476814179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Association of Spokane Dentist Past Accepting new patients
Community Health Association of Spokane Dentist Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Dentist Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Dentist Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: trang.doan.1@11411.direct.athenahealth.com

Organizations & group practices 9

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": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1659825073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024932",
            "telephone_number": "509-444-8888",
            "fax_number": "509-444-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 S MAIN ST STE 120",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432695",
            "telephone_number": "208-848-8300",
            "fax_number": "509-444-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOAN",
        "first_name": "TRANG",
        "middle_name": "MINH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-4877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, ID

Sources for this page

Verify at the official NPI Registry.