Provider Demographics
NPI:1477656924
Name:TRAN, HUY B (DDS)
Entity Type:Individual
Prefix:DR
First Name:HUY
Middle Name:B
Last Name:TRAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHRISTOPHER
Other - Middle Name:B
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3300 MATLOCK RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015
Mailing Address - Country:US
Mailing Address - Phone:817-466-8166
Mailing Address - Fax:817-557-4646
Practice Address - Street 1:515 W MAYFIELD RD
Practice Address - Street 2:STE. 302
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2083
Practice Address - Country:US
Practice Address - Phone:817-466-8166
Practice Address - Fax:817-557-4646
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX165481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120852202Medicaid
TXD16548OtherCHIPS PROVIDER NUMBER