Provider Demographics
NPI:1720409881
Name:HENRY HOANG TRAN, DMD, INC.
Entity Type:Organization
Organization Name:HENRY HOANG TRAN, DMD, INC.
Other - Org Name:UNIQUE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:H
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:714-828-1135
Mailing Address - Street 1:545 S KNOTT AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-2807
Mailing Address - Country:US
Mailing Address - Phone:714-828-1135
Mailing Address - Fax:714-828-1136
Practice Address - Street 1:545 S KNOTT AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-2807
Practice Address - Country:US
Practice Address - Phone:714-828-1135
Practice Address - Fax:714-828-1136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49423302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization