Provider Demographics
NPI:1649957911
Name:TRAN, LINDA LAM (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:LAM
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 1:3942 SNOWSHOE AVE
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-1198
Mailing Address - Country:US
Mailing Address - Phone:419-283-9347
Mailing Address - Fax:
Practice Address - Street 1:194 ROBERT SMALLS PKWY
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-3202
Practice Address - Country:US
Practice Address - Phone:843-473-3148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0271401223G0001X
SCDGD.109091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice