Healthcare Provider Details

I. General information

NPI: 1538944129
Provider Name (Legal Business Name): ANDY TRAN M.S., D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7050 AIR DEPOT BLVD BLDG 1094
TINKER AFB OK
73145-8716
US

IV. Provider business mailing address

1001 4TH ST SW APT 604
WASHINGTON DC
20024-4576
US

V. Phone/Fax

Practice location:
  • Phone: 405-582-6454
  • Fax:
Mailing address:
  • Phone: 360-628-1671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: