Individual provider Active NPI

Liem Tran, DDS

  • Dentist
  • Mountain View, CA
National Provider Identifier
1720149917
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
46701 Issued in CA
Practice address
805 E El Camino Real
Suite E
Mountain View, CA 94040-2811
Phone
(650) 254-1436
Fax
(650) 254-1463
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 46701 CA Primary

Addresses

Primary practice location

805 E El Camino Real
Suite E
Mountain View, CA 94040-2811

Mailing address

805 E El Camino Real
Suite E
Mountain View, CA 94040-2811
Phone (650) 254-1436

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
I20160601002399 CA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 1254621345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46701CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1720149917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E EL CAMINO REAL",
            "address_2": "SUITE E",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402811",
            "telephone_number": "650-254-1436",
            "fax_number": "650-254-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E EL CAMINO REAL",
            "address_2": "SUITE E",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402811",
            "telephone_number": "650-254-1436",
            "fax_number": "650-254-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "LIEM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.