Provider Demographics
NPI:1598067092
Name:KIET TRAN, DDS INC.
Entity Type:Organization
Organization Name:KIET TRAN, DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KIET
Authorized Official - Middle Name:MINH
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-600-0858
Mailing Address - Street 1:26636 MARGARITA RD STE 102
Mailing Address - Street 2:C/O DATEDENTAL.COM
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2010
Mailing Address - Country:US
Mailing Address - Phone:951-600-0858
Mailing Address - Fax:950-600-2623
Practice Address - Street 1:26636 MARGARITA RD STE 102
Practice Address - Street 2:C/O DATEDENTAL.COM
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2010
Practice Address - Country:US
Practice Address - Phone:951-600-0858
Practice Address - Fax:950-600-2623
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIET TRAN, DDS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty