Provider Demographics
NPI:1972786622
Name:VIVIAN T TRAN DDS INC
Entity Type:Organization
Organization Name:VIVIAN T TRAN DDS INC
Other - Org Name:GENTLEONE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DDS DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:TIEN
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-863-3137
Mailing Address - Street 1:PO BOX 10630
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389
Mailing Address - Country:US
Mailing Address - Phone:562-863-3137
Mailing Address - Fax:
Practice Address - Street 1:13330 BLOOMFIELD AVE
Practice Address - Street 2:STE 201
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650
Practice Address - Country:US
Practice Address - Phone:562-863-3137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51310122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty