Provider Demographics
NPI:1275841249
Name:TRAN, KIM TRINH THI
Entity Type:Individual
Prefix:
First Name:KIM TRINH
Middle Name:THI
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19075 NW TANASBOURNE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5802
Mailing Address - Country:US
Mailing Address - Phone:503-531-1700
Mailing Address - Fax:
Practice Address - Street 1:19075 NW TANASBOURNE DR. SUITE # 300
Practice Address - Street 2:
Practice Address - City:HILLBORO
Practice Address - State:OR
Practice Address - Zip Code:97124
Practice Address - Country:US
Practice Address - Phone:530-531-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant