Provider Demographics
NPI:1629587175
Name:NGUYEN D TRAN DDS INC.
Entity Type:Organization
Organization Name:NGUYEN D TRAN DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NGUYEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-357-1960
Mailing Address - Street 1:5971 UNIVERSITY AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-6334
Mailing Address - Country:US
Mailing Address - Phone:619-229-9935
Mailing Address - Fax:
Practice Address - Street 1:5971 UNIVERSITY AVE STE 309
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-6334
Practice Address - Country:US
Practice Address - Phone:619-229-9935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59707122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty