Provider Demographics
NPI:1942422100
Name:THUYVAN HOANG TRAN, DDS,INC
Entity Type:Organization
Organization Name:THUYVAN HOANG TRAN, DDS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THUYVAN
Authorized Official - Middle Name:HOANG
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-882-8025
Mailing Address - Street 1:20940 ROSCOE BLVD
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-4308
Mailing Address - Country:US
Mailing Address - Phone:818-882-8025
Mailing Address - Fax:818-882-8027
Practice Address - Street 1:20940 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-4308
Practice Address - Country:US
Practice Address - Phone:818-882-8025
Practice Address - Fax:818-882-8027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA427051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty