Provider Demographics
NPI:1528409075
Name:TRAN, JOHN QUOC (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:QUOC
Last Name:TRAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14592 EMERYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6205
Mailing Address - Country:US
Mailing Address - Phone:213-245-1095
Mailing Address - Fax:
Practice Address - Street 1:14592 EMERYWOOD RD
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6205
Practice Address - Country:US
Practice Address - Phone:213-245-1095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA623391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice