Provider Demographics
NPI:1851561989
Name:TRAN, JOHNNY H (DDS)
Entity Type:Individual
Prefix:
First Name:JOHNNY
Middle Name:H
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 1:28221 CROWN VALLEY PKWY STE E
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1427
Mailing Address - Country:US
Mailing Address - Phone:949-542-6468
Mailing Address - Fax:949-329-1306
Practice Address - Street 1:28221 CROWN VALLEY PKWY STE E
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1427
Practice Address - Country:US
Practice Address - Phone:949-542-6468
Practice Address - Fax:949-329-1306
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54842122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist