Individual provider Active NPI

Daniel The-Anh Tran, DDS

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1790257780
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36814 Issued in TX
Practice address
12453 Timberland Blvd Ste 113
Fort Worth, TX 76244-5209
Phone
(817) 431-2979
Fax
(817) 776-5067
NPI assigned
Jan 1, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 36814 TX Primary

Addresses

Primary practice location

12453 Timberland Blvd Ste 113
Fort Worth, TX 76244-5209

Mailing address

12453 Timberland Blvd Ste 113
Fort Worth, TX 76244-5209
Phone (817) 431-2979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20250909001069 OH Practitioner - Dentist 1850893736 Practice locations: Cleveland, OH

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
New York University College of Dentistry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20100 Walker Rd
Unit 235
Shaker Heights, OH 44122-3659

20100 Walker Rd Unit
Suite 235
Shaker Heights, OH 44122-3659

7570 Northcliff Ave
Cleveland, OH 44144-3252
Phone (216) 205-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36814TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1546300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1790257780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12453 TIMBERLAND BLVD STE 113",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445209",
            "telephone_number": "817-431-2979",
            "fax_number": "817-776-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12453 TIMBERLAND BLVD STE 113",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445209",
            "telephone_number": "817-431-2979",
            "fax_number": "817-776-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "DANIEL",
        "middle_name": "THE-ANH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "36814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.