Michelle Mychau Tran, D.D.S., a Professional Dental Corp.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

46225 Issued in CA

Legal business name

MICHELLE MYCHAU TRAN, D.D.S., A PROFESSIONAL DENTAL CORP.

Practice address

12683 Beach Blvd
Stanton, CA 90680-4007

Phone

(714) 372-3600

Fax

(714) 372-3705

NPI assigned

Nov 29, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Michelle Mychau Tran, D.D.S.

Title

President

Phone

(714) 372-3600

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780667386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12683 BEACH BLVD",
            "city": "STANTON",
            "state": "CA",
            "postal_code": "906804007",
            "telephone_number": "714-372-3600",
            "fax_number": "714-372-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12683 BEACH BLVD",
            "city": "STANTON",
            "state": "CA",
            "postal_code": "906804007",
            "telephone_number": "714-372-3600",
            "fax_number": "714-372-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE MYCHAU TRAN, D.D.S., A PROFESSIONAL DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "MYCHAU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-372-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G93104-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cody Miller
• Madelyn Miller
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• All providers in Stanton, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.