Provider Demographics
NPI:1770826463
Name:DANG, NAM TRAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:NAM
Middle Name:TRAN
Last Name:DANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3164 PENITENCIA CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95132-2818
Mailing Address - Country:US
Mailing Address - Phone:408-768-7092
Mailing Address - Fax:
Practice Address - Street 1:531 ELM ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4549
Practice Address - Country:US
Practice Address - Phone:203-583-4707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA632131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice