Provider Demographics
NPI:1205085933
Name:TRAN, LAN P (DMD)
Entity type:Individual
Prefix:
First Name:LAN
Middle Name:P
Last Name:TRAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7346 NE SANDY BLVD
Mailing Address - Street 2:STE A PARKROSE FAMILY DENTAL DBA ROSEWAY FAMILY DENTAL
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213
Mailing Address - Country:US
Mailing Address - Phone:503-287-7899
Mailing Address - Fax:503-287-7933
Practice Address - Street 1:7346 NE SANDY BLVD
Practice Address - Street 2:STE A PARKROSE FAMILY DENTAL DBA ROSEWAY FAMILY DENTAL
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213
Practice Address - Country:US
Practice Address - Phone:503-287-7899
Practice Address - Fax:503-287-7933
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD73631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice