Provider Demographics
NPI:1255542924
Name:TRAN, THANH (DDS)
Entity type:Individual
Prefix:DR
First Name:THANH
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5841 E CHARLESTON BLVD
Mailing Address - Street 2:#220
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-1021
Mailing Address - Country:US
Mailing Address - Phone:702-644-2222
Mailing Address - Fax:702-641-8722
Practice Address - Street 1:5841 E CHARLESTON BLVD
Practice Address - Street 2:#220
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142-1021
Practice Address - Country:US
Practice Address - Phone:702-644-2222
Practice Address - Fax:702-641-8722
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4544122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist