Provider Demographics
NPI:1447689401
Name:DIEP, TRAN (RDH)
Entity type:Individual
Prefix:MISS
First Name:TRAN
Middle Name:
Last Name:DIEP
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 LAKEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-4215
Mailing Address - Country:US
Mailing Address - Phone:228-235-5814
Mailing Address - Fax:
Practice Address - Street 1:2574 MARCIA CT
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-2341
Practice Address - Country:US
Practice Address - Phone:228-388-9545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-10
Last Update Date:2013-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS4138-13DH124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist