Provider Demographics
NPI:1003257619
Name:TRAN, TIM C (DMD)
Entity Type:Individual
Prefix:DR
First Name:TIM
Middle Name:C
Last Name:TRAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 STRANDER BLVD
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2923
Mailing Address - Country:US
Mailing Address - Phone:253-219-0146
Mailing Address - Fax:
Practice Address - Street 1:664 STRANDER BLVD
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2923
Practice Address - Country:US
Practice Address - Phone:253-219-0146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60500570122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist