Provider Demographics
NPI:1871811984
Name:AITRANG T. TRAN DENTAL INCORPORATED
Entity type:Organization
Organization Name:AITRANG T. TRAN DENTAL INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:AITRANG
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-626-1515
Mailing Address - Street 1:709 N HILL ST
Mailing Address - Street 2:#9
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2361
Mailing Address - Country:US
Mailing Address - Phone:213-626-1515
Mailing Address - Fax:
Practice Address - Street 1:709 N. HILL STREET #9
Practice Address - Street 2:
Practice Address - City:LA
Practice Address - State:CA
Practice Address - Zip Code:90012
Practice Address - Country:US
Practice Address - Phone:213-626-1515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA411391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty