Provider Demographics
NPI:1932544228
Name:TRUNG KIEN DOAN, DDS, A PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:TRUNG KIEN DOAN, DDS, A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:DENTAL ARTS CENTER OF RANCHO SANTA MARGARITA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRUNG
Authorized Official - Middle Name:KIEN
Authorized Official - Last Name:DOAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-713-6720
Mailing Address - Street 1:26111 ANTONIO PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-5597
Mailing Address - Country:US
Mailing Address - Phone:949-713-6720
Mailing Address - Fax:949-713-6721
Practice Address - Street 1:26111 ANTONIO PKWY STE 200
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-5597
Practice Address - Country:US
Practice Address - Phone:949-713-6720
Practice Address - Fax:949-713-6721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47365122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty