Individual provider Active NPI

Timmie Tran, DDS

  • Dentist
  • Mesquite, TX
National Provider Identifier
1710102736
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
17462 Issued in TX
Practice address
2411 N Galloway Ave
#128
Mesquite, TX 75150-6365
Phone
(972) 279-4411
Fax
(972) 279-4411
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 17462 TX Primary

Addresses

Primary practice location

2411 N Galloway Ave
#128
Mesquite, TX 75150-6365

Mailing address

2411 N Galloway Ave
#128
Mesquite, TX 75150-6365
Phone (972) 279-4411

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
17462TXMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mesquite Dental Clinic PLLC PastSince Nov 17, 2019 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710102736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 N GALLOWAY AVE",
            "address_2": "#128",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506365",
            "telephone_number": "972-279-4411",
            "fax_number": "972-279-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 N GALLOWAY AVE",
            "address_2": "#128",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506365",
            "telephone_number": "972-279-4411",
            "fax_number": "972-279-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "TIMMIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "17462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.