MEDICARE: VINH 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	390200000X	Student in an Organized Health Care Education/Training Program
2	1223G0001X	General Practice Dentistry	0401413899	VA

General Provider Information

NPI Number	:	1174874721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINH TRAN DDS

Provider Business Mailing Address
First Line	:	9009 ADVANTAGE CT
Second Line	:
City	:	BURKE
State	:	VA
Zip	:	22015-4902
Country	:	US
Telephone Number	:	571-232-8652
Fax Number	:

Provider Business Practice Location Address
First Line	:	6329 ARLINGTON BLVD STE C
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2015
Country	:	US
Telephone Number	:	703-237-6703
Fax Number	:

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

Provider Enumeration Date	:	09/23/2012
Last Update Date	:	04/19/2014

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