MEDICARE: AIMY THI TRAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	101608	CA

General Provider Information

NPI Number	:	1598288664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIMY THI TRAN DDS

Provider Business Mailing Address
First Line	:	5800 HAROLD WAY APT 317
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-7244
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5800 HAROLD WAY APT 317
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-7244
Country	:	US
Telephone Number	:	214-662-5544
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2017
Last Update Date	:	07/20/2017

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Directions to “ AIMY THI TRAN DDS” Practice Location

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