Provider Demographics
NPI:1902011927
Name:TRAN, YEN THI NGOC (DDS)
Entity type:Individual
Prefix:DR
First Name:YEN
Middle Name:THI NGOC
Last Name:TRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 W SPRING VALLEY RD STE B
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-4037
Mailing Address - Country:US
Mailing Address - Phone:972-480-9999
Mailing Address - Fax:
Practice Address - Street 1:327 W SPRING VALLEY RD STE B
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-4037
Practice Address - Country:US
Practice Address - Phone:972-480-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX090828703Medicaid
TX1306074OtherUNITED CONCORDIA INS
TXB19373-01OtherDELTA DENTAL