Provider Demographics
NPI:1497366843
Name:TRAN, HY K (RDH)
Entity Type:Individual
Prefix:
First Name:HY
Middle Name:K
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 1:6407 S STANLEY PL UNIT C
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3831
Mailing Address - Country:US
Mailing Address - Phone:480-289-8475
Mailing Address - Fax:
Practice Address - Street 1:6407 S STANLEY PL UNIT C
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3831
Practice Address - Country:US
Practice Address - Phone:480-289-8475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2021-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZH010011124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program