Provider Demographics
NPI:1902660251
Name:CHANG AND TRAN DENTAL INC
Entity Type:Organization
Organization Name:CHANG AND TRAN DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-541-9523
Mailing Address - Street 1:863 EL CERRO BLVD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-2704
Mailing Address - Country:US
Mailing Address - Phone:510-541-9523
Mailing Address - Fax:
Practice Address - Street 1:15609 HESPERIAN BLVD
Practice Address - Street 2:
Practice Address - City:SAN LORENZO
Practice Address - State:CA
Practice Address - Zip Code:94580-1626
Practice Address - Country:US
Practice Address - Phone:510-541-9523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental