Active NPI
Daniel The-Anh Tran, DDS
- General Practice Dentistry
- Fort Worth, TX
National Provider Identifier
1790257780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 36814
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 36814 | TX | MD | Pharmacist |
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.