Healthcare Provider Details

I. General information

NPI: 1669166179
Provider Name (Legal Business Name): TIFFANY TRAN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 06/07/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 SINGLETON RD STE 315
NORCROSS GA
30093-1967
US

IV. Provider business mailing address

6000 SINGLETON RD STE 315
NORCROSS GA
30093-1967
US

V. Phone/Fax

Practice location:
  • Phone: 770-248-9059
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN122953
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number7562
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: