Provider Demographics
NPI:1053103077
Name:TRAN, THUAN NGOC (DDS)
Entity type:Individual
Prefix:DR
First Name:THUAN
Middle Name:NGOC
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 1:4400 CHEMIN METAIRE PKWY UNIT 122
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-7063
Mailing Address - Country:US
Mailing Address - Phone:337-577-3566
Mailing Address - Fax:
Practice Address - Street 1:1143 CHURCH POINT HWY
Practice Address - Street 2:
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578-7692
Practice Address - Country:US
Practice Address - Phone:337-334-3724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA76861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice