MEDICARE: LUCENT DENTAL PLLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1255262077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUCENT DENTAL PLLC

Provider Business Mailing Address
First Line	:	9671D MAIN ST
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-3742
Country	:	US
Telephone Number	:	703-503-5211
Fax Number	:

Provider Business Practice Location Address
First Line	:	9671D MAIN ST
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-3742
Country	:	US
Telephone Number	:	703-503-5211
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. BRANDON TRAN
Credential	:	DMD
Telephone Number	:	703-503-5211

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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