Provider Demographics
NPI:1447373030
Name:TRAN NGUYEN, ROSE P (DMD)
Entity type:Individual
Prefix:DR
First Name:ROSE
Middle Name:P
Last Name:TRAN NGUYEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MISS
Other - First Name:ROSE
Other - Middle Name:P
Other - Last Name:TRAN-NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:3362 LOMA VISTA RD.
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003
Mailing Address - Country:US
Mailing Address - Phone:805-654-1961
Mailing Address - Fax:805-654-0791
Practice Address - Street 1:3362 LOMA VISTA RD.
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003
Practice Address - Country:US
Practice Address - Phone:805-654-1961
Practice Address - Fax:805-654-0791
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA383411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice