MEDICARE: TRAN TOUNIAN DDS 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	122300000X	Dentist	5586	NV
2	122300000X	Dentist	6131	NV

General Provider Information

NPI Number	:	1386997609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRAN TOUNIAN DDS PLLC

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	:	702-838-0706

Provider Business Practice Location Address
First Line	:	3073 W CRAIG RD
Second Line	:	#1
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-5122
Country	:	US
Telephone Number	:	702-838-0707
Fax Number	:	702-838-0706

Authorized Official
Title or Position	:	MEMBER
Name	:	MY TRAN
Credential	:
Telephone Number	:	702-838-0707

Provider Enumeration Date	:	10/24/2012
Last Update Date	:	10/24/2012

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