Active NPI
Trung Quang Phan, DDS
- General Practice Dentistry
- Round Rock, TX
National Provider Identifier
1902391972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 35899
- Practice address
- 581 University Blvd #400
Round Rock, TX 78665 - Phone
- (512) 244-3333
- Fax
- (512) 341-0631
- NPI assigned
- Jun 22, 2018
- Last updated
- Aug 14, 2023
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS041744 | PA | |
| General Practice Dentistry | 1223G0001X | 35899 | TX | Primary |
Addresses
Primary practice location
581 University Blvd #400
Round Rock, TX 78665
Mailing address
581 University Blvd #400
Round Rock, TX 78665
Phone (512) 244-3333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35899 | TX | MD | Endodontist |
| DS041744 | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tphan Dental PLLC | Current | Accepting new patients |
Locations
581 University Blvd
Ste 400
Round Rock, TX 78665
Phone (512) 244-3333
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691971200000",
"number": "1902391972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "581 UNIVERSITY BLVD #400",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "78665",
"telephone_number": "512-244-3333",
"fax_number": "512-341-0631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "581 UNIVERSITY BLVD #400",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "78665",
"telephone_number": "512-244-3333",
"fax_number": "512-341-0631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "TRUNG",
"middle_name": "QUANG",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-22",
"last_updated": "2023-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS041744",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "35899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.