Healthcare Provider Details

I. General information

NPI: 1710720438
Provider Name (Legal Business Name): ANNIE HANG TRAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 06/22/2025
Certification Date: 06/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13555 WELLINGTON CENTER CIR STE 105
GAINESVILLE VA
20155-4061
US

IV. Provider business mailing address

6202 WAYLES ST
SPRINGFIELD VA
22150-1225
US

V. Phone/Fax

Practice location:
  • Phone: 703-754-1580
  • Fax:
Mailing address:
  • Phone: 703-965-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number0401419576
License Number StateVA
# 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: