Provider Demographics
NPI:1326157256
Name:MAI TRAN DDS, MS, PA
Entity Type:Organization
Organization Name:MAI TRAN DDS, MS, PA
Other - Org Name:MAI ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ORTHODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:MAI
Authorized Official - Middle Name:THI
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:512-892-1188
Mailing Address - Street 1:6012 W WILLIAM CANNON DR
Mailing Address - Street 2:SUITE D-103
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-1980
Mailing Address - Country:US
Mailing Address - Phone:512-892-1188
Mailing Address - Fax:512-892-0063
Practice Address - Street 1:6012 W WILLIAM CANNON DR
Practice Address - Street 2:SUITE D-103
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-1980
Practice Address - Country:US
Practice Address - Phone:512-892-1188
Practice Address - Fax:512-892-0063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198921223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty