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NPI Code Detail

MEDICARE: DUYEN TRAN DMD

MEDICARE: DUYEN TRAN DMD
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
11223G0001XGeneral Practice Dentistry019.031667IL
2122300000XDentist019.031667IL

General Provider Information

NPI Number : 1194210013
Entity Type Code : Individual
Provider Name (Legal Business Name) : DUYEN TRAN DMD
Provider Business Mailing Address
First Line : 4119 S MAPLEWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60632-1125
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2829 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-6932
Country : US
Telephone Number : 773-528-8900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2018
Last Update Date : 03/15/2024

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Directions to “ DUYEN TRAN DMD” Practice Location

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