Healthcare Provider Details

I. General information

NPI: 1811256837
Provider Name (Legal Business Name): HAO C TRAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2012
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 BIERSTADT HTS
PEYTON CO
80831-6178
US

IV. Provider business mailing address

717 N TEJON ST
COLORADO SPRINGS CO
80903-1011
US

V. Phone/Fax

Practice location:
  • Phone: 719-985-6541
  • Fax:
Mailing address:
  • Phone: 303-901-1221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDEN.00202962
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: