MEDICARE: DR. CHRISTOPHER QUOC-DUY 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	103145	CA
2	1223E0200X	Endodontics	S7-126C	NV

General Provider Information

NPI Number	:	1700353372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER QUOC-DUY TRAN DDS

Provider Business Mailing Address
First Line	:	4565 S BONITA VISTA ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-6060
Country	:	US
Telephone Number	:	951-496-2470
Fax Number	:

Provider Business Practice Location Address
First Line	:	9690 W TROPICANA AVE STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-2601
Country	:	US
Telephone Number	:	702-876-0000
Fax Number	:

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

Provider Enumeration Date	:	10/31/2018
Last Update Date	:	05/17/2023

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