Healthcare Provider Details

I. General information

NPI: 1417878299
Provider Name (Legal Business Name): CHRISTINA TUYET-NHUNG TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6406 SUNRISE BLVD STE C
CITRUS HEIGHTS CA
95610-5992
US

IV. Provider business mailing address

449 SERPA WAY
FOLSOM CA
95630-6316
US

V. Phone/Fax

Practice location:
  • Phone: 916-727-1880
  • Fax:
Mailing address:
  • Phone: 916-532-0650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number113187
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: