Active NPI
Tram Phan, DMD
- General Practice Dentistry
- Reno, NV
National Provider Identifier
1962194365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7820
- Practice address
- 4875 Summit Ridge Dr
Reno, NV 89523-7936 - Phone
- (775) 376-7919
- NPI assigned
- May 23, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7820 | NV | Primary |
Addresses
Primary practice location
4875 Summit Ridge Dr
Reno, NV 89523-7936
Mailing address
250 S City Pkwy Unit 378
Las Vegas, NV 89106-4628
Phone (832) 798-0150
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 |
|---|---|---|---|
| 7820 | NV | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1962194365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 S CITY PKWY UNIT 378",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064628",
"telephone_number": "832-798-0150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4875 SUMMIT RIDGE DR",
"city": "RENO",
"state": "NV",
"postal_code": "895237936",
"telephone_number": "775-376-7919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "TRAM",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-23",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NV",
"license": "7820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.