Provider Demographics
NPI:1316168768
Name:CHARLES C. TRAN, DDS
Entity type:Organization
Organization Name:CHARLES C. TRAN, DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:C
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-422-5697
Mailing Address - Street 1:6930 65TH ST
Mailing Address - Street 2:SUITE 107B
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2343
Mailing Address - Country:US
Mailing Address - Phone:916-422-5697
Mailing Address - Fax:916-422-5612
Practice Address - Street 1:6930 65TH ST
Practice Address - Street 2:SUITE 107B
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2343
Practice Address - Country:US
Practice Address - Phone:916-422-5697
Practice Address - Fax:916-422-5612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37943122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty