Provider Demographics
NPI:1619968880
Name:TRAN, LINH THUY (DMD)
Entity Type:Individual
Prefix:DR
First Name:LINH
Middle Name:THUY
Last Name:TRAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 KILBOURN AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3207
Mailing Address - Country:US
Mailing Address - Phone:773-404-0101
Mailing Address - Fax:773-404-1260
Practice Address - Street 1:424 W FULLERTON PKWY
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-2812
Practice Address - Country:US
Practice Address - Phone:773-404-0101
Practice Address - Fax:773-404-1260
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1005605Medicare ID - Type UnspecifiedDORAL