MEDICARE: MRS. HA NHI TRAN D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	40993	CA

General Provider Information

NPI Number	:	1043684236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HA NHI TRAN D.D.S

Provider Business Mailing Address
First Line	:	667 N INDIAN HILL BLVD
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-5303
Country	:	US
Telephone Number	:	909-620-6664
Fax Number	:

Provider Business Practice Location Address
First Line	:	667 N INDIAN HILL BLVD
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-5303
Country	:	US
Telephone Number	:	909-620-6664
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2015
Last Update Date	:	04/12/2026

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