Provider Demographics
NPI:1528456423
Name:TRAN, TUAN M
Entity type:Individual
Prefix:DR
First Name:TUAN
Middle Name:M
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12860 DARNICK CT
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-2550
Mailing Address - Country:US
Mailing Address - Phone:202-331-3881
Mailing Address - Fax:202-331-3883
Practice Address - Street 1:1800 K ST NW STE 305
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-2225
Practice Address - Country:US
Practice Address - Phone:202-331-3881
Practice Address - Fax:202-331-3883
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1000182122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist