Individual provider Active NPI

Amanda Tran, DMD

  • Pediatric Dentistry
  • Philadelphia, PA
National Provider Identifier
1700358041
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS042024 Issued in PA
Practice address
240 Geiger Rd
Philadelphia, PA 19115-1008
Phone
(215) 464-2411
NPI assigned
Dec 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS042024 PA
General Practice Dentistry 1223G0001X DL14824 MA
Pediatric Dentistry 1223P0221X DS042024 PA Primary

Addresses

Primary practice location

240 Geiger Rd
Philadelphia, PA 19115-1008

Mailing address

1601 Spring Garden St Apt M111
Philadelphia, PA 19130-3942
Phone (215) 255-5907

Other practice location 1

1 Kneeland St
Boston, MA 02111-1527
Phone (617) 636-6971

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
DL14824MAMDGeneral Practice Dentistry
DS042024PAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1700358041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 SPRING GARDEN ST APT M111",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303942",
            "telephone_number": "215-255-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 GEIGER RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191151008",
            "telephone_number": "215-464-2411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Kneeland St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111527",
            "country_code": "US",
            "telephone_number": "617-636-6971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-27",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS042024",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DL14824",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS042024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.