Provider Demographics
NPI:1144830571
Name:HUEY Q TRAN, DDS, INC.
Entity type:Organization
Organization Name:HUEY Q TRAN, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HUEY
Authorized Official - Middle Name:QUANG
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-302-7508
Mailing Address - Street 1:12363 LIMONITE AVE STE 960
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:91752
Mailing Address - Country:US
Mailing Address - Phone:951-360-2020
Mailing Address - Fax:951-360-2022
Practice Address - Street 1:12363 LIMONITE AVE STE 960
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:91752
Practice Address - Country:US
Practice Address - Phone:951-360-2020
Practice Address - Fax:951-360-2022
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUEY Q TRAN, DDS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1578013926OtherN/A