Provider Demographics
NPI:1629656756
Name:TRAN, HONG-ANH NGOC (DMD)
Entity Type:Individual
Prefix:DR
First Name:HONG-ANH
Middle Name:NGOC
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 1:2250 OLD IVY RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4820
Mailing Address - Country:US
Mailing Address - Phone:434-293-8944
Mailing Address - Fax:
Practice Address - Street 1:2250 OLD IVY RD STE 3
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4820
Practice Address - Country:US
Practice Address - Phone:434-293-8944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014179391223G0001X, 122300000X
OHRES004350390200000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program