Provider Demographics
NPI:1477982346
Name:TRAN, TIPHANIE (DDS)
Entity Type:Individual
Prefix:
First Name:TIPHANIE
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2664 BERRYESSA RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95132-2925
Mailing Address - Country:US
Mailing Address - Phone:408-251-6217
Mailing Address - Fax:408-251-6830
Practice Address - Street 1:2664 BERRYESSA ROAD
Practice Address - Street 2:SUITE 209
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95132
Practice Address - Country:US
Practice Address - Phone:408-251-6217
Practice Address - Fax:408-251-6830
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40051122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist