Provider Demographics
NPI:1881768521
Name:TRAN, ROBIN THUCANH PHAM (DDS)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:THUCANH PHAM
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 1:2351 MC KEE RD, STE B
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1624
Mailing Address - Country:US
Mailing Address - Phone:408-272-8145
Mailing Address - Fax:408-272-8874
Practice Address - Street 1:2351 MCKEE RD STE B
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1623
Practice Address - Country:US
Practice Address - Phone:408-730-5872
Practice Address - Fax:408-730-5872
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice