Provider Demographics
NPI:1225080641
Name:TRAM, ANH THU (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANH
Middle Name:THU
Last Name:TRAM
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 1:13722 TYPEE WAY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3272
Mailing Address - Country:US
Mailing Address - Phone:949-654-7882
Mailing Address - Fax:714-242-1777
Practice Address - Street 1:12859 PALM ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-6401
Practice Address - Country:US
Practice Address - Phone:714-534-1434
Practice Address - Fax:714-242-1777
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA397191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD39719OtherDENTICAL