Provider Demographics
NPI:1861851289
Name:MY G TRAN DDS INC
Entity Type:Organization
Organization Name:MY G TRAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MY
Authorized Official - Middle Name:G
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-997-7707
Mailing Address - Street 1:31726 RANCHO VIEJO RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-2723
Mailing Address - Country:US
Mailing Address - Phone:949-303-1307
Mailing Address - Fax:
Practice Address - Street 1:7545 W SAHARA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2866
Practice Address - Country:US
Practice Address - Phone:702-997-7707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty