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General NPI Number Information
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NPI Number | 1154905990
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Entity Type | Organization
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Legal Business Name | YEN HAI DUONG, DDS & JIMMY TRAN, DMD, INC.
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Dates
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Enumeration Date | 05/07/2021
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 18102 IRVINE BLVD STE 212
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City | TUSTIN
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State | CA
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Zip | 92780-3424
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Country | US
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Telephone | 714-714-0818
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Fax |
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Provider Business Mailing Address
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Address Line | 9317 BOLSA AVE UNIT 2099
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City | WESTMINSTER
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State | CA
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Zip | 92684-2321
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Country | US
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Telephone | 714-714-0818
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | JIMMY BINH-PHI TRAN
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Credential | DMD
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Telephone | 714-714-0818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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