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General NPI Number Information
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NPI Number | 1497082739
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Entity Type | Individual
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Provider Name | KRISTINA THAI TRAN DDS
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Gender | Female
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Dates
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Enumeration Date | 11/06/2009
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Last Update Date | 01/09/2019
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Provider Practice Location Address
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Address Line | 1450 FRUITVALE AVE
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City | OAKLAND
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State | CA
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Zip | 94601-2313
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Country | US
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Telephone | 925-363-1256
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Fax |
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Provider Business Mailing Address
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Address Line | 8 10TH ST APT 1706
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City | SAN FRANCISCO
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State | CA
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Zip | 94103-1396
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Country | US
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Telephone | 917-231-5286
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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 | 044505
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 102294
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License Number State | CA
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