Provider Demographics
NPI:1588076335
Name:TRAN, BRITNIE NGUYETQUE (DMD)
Entity type:Individual
Prefix:
First Name:BRITNIE
Middle Name:NGUYETQUE
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 1:210 MEADOW VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3495
Mailing Address - Country:US
Mailing Address - Phone:757-673-6263
Mailing Address - Fax:757-392-3943
Practice Address - Street 1:114 RIVER RD S
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-2244
Practice Address - Country:US
Practice Address - Phone:484-442-0231
Practice Address - Fax:434-432-0425
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014144411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice