Provider Demographics
NPI:1629102298
Name:CINDY HANH NGUYEN TRAN DDS INC
Entity Type:Organization
Organization Name:CINDY HANH NGUYEN TRAN DDS INC
Other - Org Name:SOUTH BEACH DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:HAHN
Authorized Official - Last Name:NGUYEN TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-848-1411
Mailing Address - Street 1:17941 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7103
Mailing Address - Country:US
Mailing Address - Phone:714-848-1411
Mailing Address - Fax:
Practice Address - Street 1:17941 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7103
Practice Address - Country:US
Practice Address - Phone:714-848-1411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD50420Medicare ID - Type UnspecifiedRENDERING PROVIDER NUMBER
CAG93740-01Medicare ID - Type UnspecifiedPROVIDER ID NUMBER