Individual provider Active NPI

Troy Bancha Tran, DMD, MSD

  • Periodontics
  • Houston, TX
National Provider Identifier
1679066526
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
36292 Issued in TX
Practice address
16415 Canario Dr
Houston, TX 77083-3771
Phone
(832) 518-6943
NPI assigned
Jun 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10145 KY
Dentist 122300000X 23568 FL
Periodontics 1223P0300X 36292 TX Primary

Addresses

Primary practice location

16415 Canario Dr
Houston, TX 77083-3771

Mailing address

16415 Canario Dr
Houston, TX 77083-3771
Phone (832) 518-6943

Other practice location 1

501 S Preston St
Louisville, KY 40202-1701
Phone (502) 852-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
23568FLMDDentist
10145KYMDDentist
36292TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1679066526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16415 CANARIO DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770833771",
            "telephone_number": "832-518-6943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16415 CANARIO DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770833771",
            "telephone_number": "832-518-6943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Preston St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021701",
            "country_code": "US",
            "telephone_number": "502-852-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "TROY",
        "middle_name": "BANCHA",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-14",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10145",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "23568",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "36292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.