Provider Demographics
NPI:1902897119
Name:TRANDAI, ANHMINH (DMD)
Entity type:Individual
Prefix:DR
First Name:ANHMINH
Middle Name:
Last Name:TRANDAI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 KILBOURN AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3207
Mailing Address - Country:US
Mailing Address - Phone:773-878-4800
Mailing Address - Fax:773-878-8444
Practice Address - Street 1:5449 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-1703
Practice Address - Country:US
Practice Address - Phone:773-878-4800
Practice Address - Fax:773-878-8444
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice