Provider Demographics
NPI:1427133495
Name:TRAN, UYEN C (DDS)
Entity type:Individual
Prefix:
First Name:UYEN
Middle Name:C
Last Name:TRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SAM
Other - Middle Name:C
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:702 SW 294TH ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-3542
Mailing Address - Country:US
Mailing Address - Phone:206-790-0223
Mailing Address - Fax:253-288-9631
Practice Address - Street 1:902 A ST SE
Practice Address - Street 2:SUITE A
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-6056
Practice Address - Country:US
Practice Address - Phone:253-288-9608
Practice Address - Fax:253-288-9631
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA94101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1452609OtherUNITED CONCORDIA
WA5040647Medicaid