Individual provider Active NPI

Mimi Nhi-Uyen Tran, D.D.S.

  • Dentist
  • Keller, TX
National Provider Identifier
1760604599
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20299 Issued in TX
Practice address
1686 Keller Pkwy Ste 100
Keller, TX 76248-3702
Phone
(682) 978-3960
Fax
(817) 745-1100
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 20299 TX Primary

Addresses

Primary practice location

1686 Keller Pkwy Ste 100
Keller, TX 76248-3702

Mailing address

1686 Keller Pkwy Ste 100
Keller, TX 76248-3702
Phone (682) 978-3960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250326002406 TX Practitioner - Dentist 9335660166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Case Western University School of Dental Medicine, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1686 Keller Pkwy
Suite 100
Keller, TX 76248-3702
Phone (682) 978-3960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20299TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tranquil Sleep Solution LLC General Practice CurrentSince Dec 23, 2024 Accepting new patients
Mimi Family Dental Dentist Past Accepting new patients

Locations

1686 Keller Pkwy
Ste 100
Keller, TX 76248
Phone (682) 978-3960

Organizations & group practices 2

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1760604599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1686 KELLER PKWY STE 100",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483702",
            "telephone_number": "682-978-3960",
            "fax_number": "817-745-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1686 KELLER PKWY STE 100",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483702",
            "telephone_number": "682-978-3960",
            "fax_number": "817-745-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "MIMI",
        "middle_name": "NHI-UYEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "20299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.