Provider Demographics
NPI:1881248573
Name:TRAN, VIET (DMD)
Entity type:Individual
Prefix:DR
First Name:VIET
Middle Name:
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 1:909 DAIRY ASHFORD RD STE 113
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-5306
Mailing Address - Country:US
Mailing Address - Phone:225-993-2907
Mailing Address - Fax:
Practice Address - Street 1:909 DAIRY ASHFORD RD STE 113
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5306
Practice Address - Country:US
Practice Address - Phone:281-493-0061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN24653122300000X
TX36056122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes122300000XDental ProvidersDentist