Provider Demographics
NPI:1003930561
Name:TRAN, HA T (DDS)
Entity Type:Individual
Prefix:
First Name:HA
Middle Name:T
Last Name:TRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10210 SCYENE RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-4930
Mailing Address - Country:US
Mailing Address - Phone:972-329-7645
Mailing Address - Fax:972-329-7647
Practice Address - Street 1:10210 SCYENE RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-4930
Practice Address - Country:US
Practice Address - Phone:972-329-7645
Practice Address - Fax:972-329-7647
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159007702Medicaid
TX159007704Medicaid