Provider Demographics
NPI:1013336866
Name:TIEP M. TRAN DDS INC.
Entity type:Organization
Organization Name:TIEP M. TRAN DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUNG
Authorized Official - Middle Name:XUAN
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-539-8899
Mailing Address - Street 1:12732 BROOKHURST ST
Mailing Address - Street 2:P.O BOX 0752
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-4810
Mailing Address - Country:US
Mailing Address - Phone:714-539-8899
Mailing Address - Fax:714-539-8999
Practice Address - Street 1:12732 BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4810
Practice Address - Country:US
Practice Address - Phone:714-539-8899
Practice Address - Fax:714-539-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49300261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental