Provider Demographics
NPI:1619041001
Name:TRAN, MUN NGA (DDS)
Entity type:Individual
Prefix:DR
First Name:MUN
Middle Name:NGA
Last Name:TRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 GREEN ACRE DR
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3603
Mailing Address - Country:US
Mailing Address - Phone:714-651-5521
Mailing Address - Fax:714-484-1078
Practice Address - Street 1:10342 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:CA
Practice Address - Zip Code:90680-1607
Practice Address - Country:US
Practice Address - Phone:714-484-1217
Practice Address - Fax:714-484-1078
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA494211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice