Provider Demographics
NPI:1760761662
Name:TRAN, STEPHANY M (DDS)
Entity Type:Individual
Prefix:
First Name:STEPHANY
Middle Name:M
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 1:451 KANSAS ST
Mailing Address - Street 2:UNIT 351
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-2342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2355 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-2600
Practice Address - Country:US
Practice Address - Phone:415-334-9500
Practice Address - Fax:415-334-9591
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60549122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist