Individual provider Active NPI

Kim-Linh Laurie Tran, D.M.D.

  • General Practice Dentistry
  • Broomall, PA
National Provider Identifier
1962583245
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS035831 Issued in PA
Practice address
2002 Sproul Rd Ste 100
Broomall, PA 19008-3510
Phone
(610) 325-1670
Fax
(610) 325-1675
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS035831 PA Primary

Addresses

Primary practice location

2002 Sproul Rd Ste 100
Broomall, PA 19008-3510

Mailing address

2002 Sproul Rd Ste 100
Broomall, PA 19008-3510
Phone (610) 325-1670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20160608000385 PA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779873492

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
KT Dental LLC CurrentSince Feb 14, 2021 Accepting new patients
Elliot Ramer, DMD Family Dentistry General Practice Past Accepting new patients

Locations

2002 Sproul Rd
Ste 100
Broomall, PA 19008
Phone (610) 325-1670

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1962583245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 SPROUL RD STE 100",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083510",
            "telephone_number": "610-325-1670",
            "fax_number": "610-325-1675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 SPROUL RD STE 100",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083510",
            "telephone_number": "610-325-1670",
            "fax_number": "610-325-1675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "KIM-LINH",
        "middle_name": "LAURIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-02-09",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS035831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomall, PA

Sources for this page

Verify at the official NPI Registry.