NPIMap

Organization Active NPI

Tphan Dental PLLC

  • Dentist
  • Round Rock, TX
National Provider Identifier
1891453718
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
TPHAN DENTAL PLLC
Practice address
581 University Blvd Ste 400
Round Rock, TX 78665-1068
Phone
(512) 244-3333
NPI assigned
Dec 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Authorized official

Name
Trung Phan, DDSNPI 1902391972
Title
Owner
Phone
(703) 608-3760

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

581 University Blvd Ste 400
Round Rock, TX 78665-1068

Mailing address

581 University Blvd Ste 400
Round Rock, TX 78665-1068
Phone (512) 244-3333

Other identifiers 1

IdentifierTypeStateIssuer
1902391972OtherNPI

Other names 1

  • Moment Dental Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL other Other

National Provider Directory

National Provider Directory

Locations

581 University Blvd
Ste 400
Round Rock, TX 78665
Phone (512) 244-3333

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669161600000",
    "number": "1891453718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "581 UNIVERSITY BLVD STE 400",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651068",
            "telephone_number": "512-244-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 UNIVERSITY BLVD STE 400",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651068",
            "telephone_number": "512-244-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TPHAN DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "TRUNG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-608-3760",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1902391972",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "other",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "n/a",
            "address_1": "581 University Blvd Ste 400",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Moment Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moment Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.