Provider Demographics
NPI:1568625358
Name:ELIZABETH L. TRAN D.M.D, INC.
Entity Type:Organization
Organization Name:ELIZABETH L. TRAN D.M.D, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:714-850-9121
Mailing Address - Street 1:2657 W EDINGER AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-3521
Mailing Address - Country:US
Mailing Address - Phone:714-850-9121
Mailing Address - Fax:714-850-9217
Practice Address - Street 1:2657 W EDINGER AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-3521
Practice Address - Country:US
Practice Address - Phone:714-850-9121
Practice Address - Fax:714-850-9217
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELIZABETH L. TRAN D.M.D, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA498161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93934-02OtherDENTI-CAL