Provider Demographics
NPI:1083766570
Name:TRAN, DAT MINH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAT
Middle Name:MINH
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 1:4621 WHITE LANE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309
Mailing Address - Country:US
Mailing Address - Phone:661-834-4400
Mailing Address - Fax:661-834-6600
Practice Address - Street 1:4621 WHITE LANE
Practice Address - Street 2:SUITE B
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309
Practice Address - Country:US
Practice Address - Phone:661-834-4400
Practice Address - Fax:661-834-6600
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47669122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist