Provider Demographics
NPI:1679728323
Name:TRAN, NGA VAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:NGA
Middle Name:VAN
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 1:1126 N FLOWER ST STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-2385
Mailing Address - Country:US
Mailing Address - Phone:714-542-4290
Mailing Address - Fax:714-542-1357
Practice Address - Street 1:1126 N FLOWER ST STE B
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-2385
Practice Address - Country:US
Practice Address - Phone:714-542-4290
Practice Address - Fax:714-542-1357
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40034122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist