MEDICARE: DR. AMELIA TRAN DDS, MS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	11493	TN

General Provider Information

NPI Number	:	1285204206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMELIA TRAN DDS, MS

Provider Business Mailing Address
First Line	:	448 HIGHPOINT TER
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-8841
Country	:	US
Telephone Number	:	870-833-1772
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 NASHVILLE HWY
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-2016
Country	:	US
Telephone Number	:	931-490-3488
Fax Number	:

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

Provider Enumeration Date	:	06/30/2021
Last Update Date	:	07/21/2023

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