Provider Demographics
NPI:1366518474
Name:TRAN, MY- ANH (DMD)
Entity type:Individual
Prefix:DR
First Name:MY- ANH
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13048 W RANCHO SANTA FE BLVD
Mailing Address - Street 2:STE 114
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-1707
Mailing Address - Country:US
Mailing Address - Phone:623-536-3377
Mailing Address - Fax:623-536-3088
Practice Address - Street 1:13048 W RANCHO SANTA FE BLVD STE 114
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-1707
Practice Address - Country:US
Practice Address - Phone:623-536-3377
Practice Address - Fax:623-536-3088
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550211223G0001X
AZD069701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice