Provider Demographics
NPI:1932317401
Name:TRAN, DAO (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAO
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:AMANDA DAO
Other - Middle Name:
Other - Last Name:TRAN-CLARK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5548 S FENTON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80123-0680
Mailing Address - Country:US
Mailing Address - Phone:303-935-0496
Mailing Address - Fax:
Practice Address - Street 1:1013 S FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-4101
Practice Address - Country:US
Practice Address - Phone:303-935-0496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO73151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice