Provider Demographics
NPI:1659415339
Name:TRAN, THUY T (DDS)
Entity Type:Individual
Prefix:DR
First Name:THUY
Middle Name:T
Last Name:TRAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18245 US HIGHWAY 18
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2217
Mailing Address - Country:US
Mailing Address - Phone:760-242-2977
Mailing Address - Fax:
Practice Address - Street 1:18245 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2217
Practice Address - Country:US
Practice Address - Phone:760-242-2977
Practice Address - Fax:409-744-4541
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1096741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice