Provider Demographics
NPI:1710123104
Name:TON, DIEU TRANG NU (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIEU TRANG
Middle Name:NU
Last Name:TON
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 1:1547 SARATOGA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-4938
Mailing Address - Country:US
Mailing Address - Phone:408-725-3740
Mailing Address - Fax:408-725-7928
Practice Address - Street 1:1547 SARATOGA AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-4938
Practice Address - Country:US
Practice Address - Phone:408-725-3740
Practice Address - Fax:408-725-7928
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA425041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice