Theodora Triphon, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

104188 Issued in CA

Practice address

13297 Jamboree Rd
Tustin, CA 92782-9159

Phone

(714) 730-6600

Fax

(951) 776-1571

NPI assigned

Apr 8, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Teddi Triphon Other name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lustig and Young Dental Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Tustin, CA
  • NPI 1255634903
  NPD

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

{
    "created_epoch": "1523145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719100800000",
    "number": "1871090720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13297 JAMBOREE RD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927829159",
            "telephone_number": "714-730-6600",
            "fax_number": "951-776-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13297 JAMBOREE RD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927829159",
            "telephone_number": "714-730-6600",
            "fax_number": "951-776-1571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1130 N Pepper Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923246717",
            "country_code": "US",
            "telephone_number": "909-422-0007",
            "fax_number": "951-776-1571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18876 Van Buren Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925089114",
            "country_code": "US",
            "telephone_number": "951-776-1376",
            "fax_number": "951-776-1571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31577 Canyon Estates Dr Ste 215",
            "address_purpose": "LOCATION",
            "city": "Lake Elsinore",
            "state": "CA",
            "postal_code": "925320473",
            "country_code": "US",
            "telephone_number": "951-471-0194",
            "fax_number": "951-776-1571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "136 W Nuevo Rd Ste G",
            "address_purpose": "LOCATION",
            "city": "Perris",
            "state": "CA",
            "postal_code": "925710859",
            "country_code": "US",
            "telephone_number": "951-943-0666",
            "fax_number": "951-776-1571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1810 Fullerton Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928813109",
            "country_code": "US",
            "telephone_number": "951-736-5700",
            "fax_number": "951-776-1571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRIPHON",
        "first_name": "THEODORA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-08",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104188",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "104188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TEDDI",
            "last_name": "TRIPHON",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Catherine Trinh, PHARM.D
• Cecilia Thuy Trinh, OTR/L
• Tuyen To Trinh, RPH
• Van T Trinh, DDS
• Nicole Trinidad
• True Life Clinic, PC
• Elizabeth Trujillo, RN
• Luz Trujillo
• Gretchen F Trumpf, PT
• Vicky Truong-Mirhossein

• Orthodontics and Dentofacial Orthopedics Dentistry in Tustin, CA
• Providers in Tustin, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.