Provider Demographics
NPI:1902865173
Name:TO, TRANG THI AN (DDS)
Entity Type:Individual
Prefix:MISS
First Name:TRANG
Middle Name:THI AN
Last Name:TO
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 1:4452 GARY WAY
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026
Mailing Address - Country:US
Mailing Address - Phone:614-777-4470
Mailing Address - Fax:
Practice Address - Street 1:1570 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-2755
Practice Address - Country:US
Practice Address - Phone:614-258-3880
Practice Address - Fax:614-252-5873
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30021454122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2278128Medicaid