Provider Demographics
NPI:1710076864
Name:TRAN, VAN THANH (DDS)
Entity Type:Individual
Prefix:DR
First Name:VAN
Middle Name:THANH
Last Name:TRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3766 NASH CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95111-1546
Mailing Address - Country:US
Mailing Address - Phone:408-375-5632
Mailing Address - Fax:
Practice Address - Street 1:219 N SANBORN RD
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93905-2218
Practice Address - Country:US
Practice Address - Phone:831-757-1365
Practice Address - Fax:831-757-2824
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49229122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist