Provider Demographics
NPI:1124063169
Name:TRAN, BINH T (DDS)
Entity type:Individual
Prefix:DR
First Name:BINH
Middle Name:T
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 1:1014 S 320TH ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5344
Mailing Address - Country:US
Mailing Address - Phone:253-529-0123
Mailing Address - Fax:
Practice Address - Street 1:1014 S 320TH ST
Practice Address - Street 2:SUITE E
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5344
Practice Address - Country:US
Practice Address - Phone:253-529-0123
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA64031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5047782Medicaid