Healthcare Provider Details

I. General information

NPI: 1033044789
Provider Name (Legal Business Name): LAWRENCE TRAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14830 LOS GATOS BLVD STE 202
LOS GATOS CA
95032-2053
US

IV. Provider business mailing address

264 PALM VALLEY BLVD APT 107
SAN JOSE CA
95123-1044
US

V. Phone/Fax

Practice location:
  • Phone: 408-378-8773
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number113115
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: