Provider Demographics
NPI:1205235538
Name:TRAN, TIN QUAN (DMD)
Entity type:Individual
Prefix:DR
First Name:TIN
Middle Name:QUAN
Last Name:TRAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 CASTLEGATE DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95132-1711
Mailing Address - Country:US
Mailing Address - Phone:408-425-4880
Mailing Address - Fax:
Practice Address - Street 1:1730 CASTLEGATE DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95132-1711
Practice Address - Country:US
Practice Address - Phone:408-425-4880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63972122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist