Provider Demographics
NPI:1790767564
Name:TRAN, TODD V (DDS)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:V
Last Name:TRAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 NILES ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-5006
Mailing Address - Country:US
Mailing Address - Phone:661-631-0355
Mailing Address - Fax:661-631-2830
Practice Address - Street 1:2010 NILES ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-5006
Practice Address - Country:US
Practice Address - Phone:661-631-0355
Practice Address - Fax:661-631-2830
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49012122300000X
CA47878122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist