Provider Demographics
NPI:1902945066
Name:TRAN, SANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANG
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9329 KEEFE DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7640
Mailing Address - Country:US
Mailing Address - Phone:530-758-7996
Mailing Address - Fax:530-207-3385
Practice Address - Street 1:1756 PICASSO AVE
Practice Address - Street 2:SUITE D
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-0549
Practice Address - Country:US
Practice Address - Phone:530-758-7996
Practice Address - Fax:530-207-3385
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA478151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice