Provider Demographics
NPI:1114138245
Name:CENTER FOR COSMETIC DENTISTRY
Entity Type:Organization
Organization Name:CENTER FOR COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TUAN
Authorized Official - Middle Name:MINH
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:202-331-3881
Mailing Address - Street 1:1800 K ST NW STE 305
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-2225
Mailing Address - Country:US
Mailing Address - Phone:202-331-3881
Mailing Address - Fax:202-331-3883
Practice Address - Street 1:1800 K ST NW STE 305
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-2225
Practice Address - Country:US
Practice Address - Phone:202-331-3881
Practice Address - Fax:202-331-3883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10001821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty