Provider Demographics
NPI:1891100921
Name:TRAN, MY-HAN SANDY (DDS)
Entity Type:Individual
Prefix:
First Name:MY-HAN
Middle Name:SANDY
Last Name:TRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 SANDCHERRY LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-5974
Mailing Address - Country:US
Mailing Address - Phone:630-890-4234
Mailing Address - Fax:
Practice Address - Street 1:70 STRATFORD DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2201
Practice Address - Country:US
Practice Address - Phone:630-893-5253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019029842122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist