Provider Demographics
NPI:1245246636
Name:TRAN, MINH-DUC VU (DMD)
Entity Type:Individual
Prefix:
First Name:MINH-DUC
Middle Name:VU
Last Name:TRAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8340 TERRA GRANDE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-3512
Mailing Address - Country:US
Mailing Address - Phone:267-250-0594
Mailing Address - Fax:
Practice Address - Street 1:6408 SEVEN CORNERS PL STE H
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2011
Practice Address - Country:US
Practice Address - Phone:703-538-4630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2015-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0356381223G0001X
MD132311223G0001X
DCDEN10004361223G0001X
VA0401411807122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice