MEDICARE: ALLIE & SELINA TRAN PC

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	0401410199	VA

General Provider Information

NPI Number	:	1508031386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIE & SELINA TRAN PC

Provider Business Mailing Address
First Line	:	6134-A ARLINGTON BLVD
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044
Country	:	US
Telephone Number	:	703-237-4521
Fax Number	:	703-237-4679

Provider Business Practice Location Address
First Line	:	6134-A ARLINGTON BLVD
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2901
Country	:	US
Telephone Number	:	703-237-4521
Fax Number	:	703-237-4679

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALLIE NHU-UYEN TRAN
Credential	:	DDS
Telephone Number	:	703-237-4521

Provider Enumeration Date	:	04/23/2008
Last Update Date	:	05/07/2008

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