Provider Demographics
NPI:1326496845
Name:TAM-HUONG TRAN DDS INC
Entity Type:Organization
Organization Name:TAM-HUONG TRAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAM-HOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-669-7705
Mailing Address - Street 1:PO BOX 1962
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-0962
Mailing Address - Country:US
Mailing Address - Phone:714-669-7705
Mailing Address - Fax:
Practice Address - Street 1:13362 NEWPORT AVE
Practice Address - Street 2:SUITE D
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3427
Practice Address - Country:US
Practice Address - Phone:714-669-7705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty