Provider Demographics
NPI:1841242310
Name:TRAN, AN THUAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:AN
Middle Name:THUAN
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 1:13830 SAN PABLO AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3758
Mailing Address - Country:US
Mailing Address - Phone:510-233-4200
Mailing Address - Fax:510-233-4210
Practice Address - Street 1:13830 SAN PABLO AVE
Practice Address - Street 2:SUITE F
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3758
Practice Address - Country:US
Practice Address - Phone:510-233-4200
Practice Address - Fax:510-233-4210
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA422411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice