MEDICARE: TRAN LE TRAN AND TOUNIAN DENTAL

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	46907	CA
2	122300000X	Dentist	55892	CA
3	122300000X	Dentist	56027	CA
4	122300000X	Dentist	42434	CA

General Provider Information

NPI Number	:	1275876203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRAN LE TRAN AND TOUNIAN DENTAL

Provider Business Mailing Address
First Line	:	7545 W SAHARA AVE
Second Line	:	200
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2866
Country	:	US
Telephone Number	:	702-838-0707
Fax Number	:

Provider Business Practice Location Address
First Line	:	23595 MOULTON PKWY
Second Line	:	1
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1939
Country	:	US
Telephone Number	:	702-838-0707
Fax Number	:

Authorized Official
Title or Position	:	GENERAL PARTNER
Name	:	MY TRAN
Credential	:	DDS
Telephone Number	:	702-755-9911

Provider Enumeration Date	:	03/27/2013
Last Update Date	:	03/27/2013

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