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General NPI Number Information
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NPI Number | 1487363230
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Entity Type | Individual
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Provider Name | TAN DAT TRAN
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Gender | Male
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Dates
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Enumeration Date | 11/21/2022
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 18640 FARM TO MARKET RD 1488 SUITE I
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City | MAGNOLIA
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State | TX
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Zip | 77354
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Country | US
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Telephone | 832-379-5488
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Fax |
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Provider Business Mailing Address
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Address Line | 14227 ANDREA WAY LN
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City | HOUSTON
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State | TX
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Zip | 77083-7711
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Country | US
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Telephone | 346-531-0182
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 38904
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License Number State | TX
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