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General NPI Number Information
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NPI Number | 1538913603
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Entity Type | Organization
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Legal Business Name | JENNIFER TRANG XA, D.D.S, INC.
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Dates
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Enumeration Date | 04/15/2024
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 735 N ESCONDIDO BLVD # A
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City | ESCONDIDO
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State | CA
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Zip | 92025-1703
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Country | US
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Telephone | 760-456-4888
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Fax | 760-456-4889
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Provider Business Mailing Address
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Address Line | 9225 MIRA MESA BLVD STE 103
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City | SAN DIEGO
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State | CA
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Zip | 92126-4810
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Country | US
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Telephone | 858-776-5485
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Fax |
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Authorized Official
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Title or Position | DENTIST - ASSOCIATE
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Name | DR. BRIAN LUONG
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Credential | DMD
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Telephone | 858-776-5485
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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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