Healthcare Provider Details

I. General information

NPI: 1033034103
Provider Name (Legal Business Name): VIVIAN TRAN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3216 NE 45TH PL STE 211
SEATTLE WA
98105-4028
US

IV. Provider business mailing address

19022 9TH PL NW
SHORELINE WA
98177-2651
US

V. Phone/Fax

Practice location:
  • Phone: 206-457-1315
  • Fax:
Mailing address:
  • Phone: 206-327-8259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDENT.DE.70150148
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: