Provider Demographics
NPI:1417519224
Name:TRAN, NGAN PHAN KIEU (RDH)
Entity Type:Individual
Prefix:
First Name:NGAN
Middle Name:PHAN KIEU
Last Name:TRAN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4513 S HOLDEN ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-4119
Mailing Address - Country:US
Mailing Address - Phone:425-301-3409
Mailing Address - Fax:
Practice Address - Street 1:720 8TH AVE S STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3034
Practice Address - Country:US
Practice Address - Phone:206-788-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist