Provider Demographics
NPI:1073950143
Name:TRAN, VINH QUANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINH
Middle Name:QUANG
Last Name:TRAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10409 PACIFIC PALISADES AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-1221
Mailing Address - Country:US
Mailing Address - Phone:808-229-6822
Mailing Address - Fax:
Practice Address - Street 1:10409 PACIFIC PALISADES AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-1221
Practice Address - Country:US
Practice Address - Phone:808-229-6822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-25361223X0008X
NV79511223X0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology