Provider Demographics
NPI:1174680268
Name:CHARLES C. TRAN, DDS
Entity Type:Organization
Organization Name:CHARLES C. TRAN, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:C
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-204-8668
Mailing Address - Street 1:6175 STOCKTON BLVD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95824-4521
Mailing Address - Country:US
Mailing Address - Phone:916-427-6263
Mailing Address - Fax:916-427-4843
Practice Address - Street 1:6175 STOCKTON BLVD
Practice Address - Street 2:SUITE 260
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95824-4521
Practice Address - Country:US
Practice Address - Phone:916-427-6263
Practice Address - Fax:916-427-4843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA379431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty