MEDICARE: DR. NHU-UYEN TRAN DDS

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	0401410199	VA

General Provider Information

NPI Number	:	1093859712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NHU-UYEN TRAN DDS

Provider Business Mailing Address
First Line	:	6440 SOUTH ST
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22042-2357
Country	:	US
Telephone Number	:	703-237-4521
Fax Number	:	703-237-4679

Provider Business Practice Location Address
First Line	:	6134A ARLINGTON BLVD
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2901
Country	:	US
Telephone Number	:	703-237-4521
Fax Number	:	703-237-4679

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

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	07/08/2007

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