Provider Demographics
NPI:1821011354
Name:TRAN, QUYNH (DDS)
Entity type:Individual
Prefix:
First Name:QUYNH
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3140
Mailing Address - Country:US
Mailing Address - Phone:951-372-0775
Mailing Address - Fax:951-372-0970
Practice Address - Street 1:1919 1ST ST
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-3140
Practice Address - Country:US
Practice Address - Phone:951-372-0775
Practice Address - Fax:951-372-0970
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA511471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice