MEDICARE: LINDA TRAN DDS A PDC

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	1223P0221X	Pediatric Dentistry	40124	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720584790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDA TRAN DDS A PDC

Provider Business Mailing Address
First Line	:	3991 GRAND AVE STE D
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-5442
Country	:	US
Telephone Number	:	909-591-0077
Fax Number	:	909-591-7711

Provider Business Practice Location Address
First Line	:	3991 GRAND AVE STE D
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-5442
Country	:	US
Telephone Number	:	909-591-0077
Fax Number	:	909-591-7711

Authorized Official
Title or Position	:	CEO/DENTIST
Name	:	DR. LINDA LINH TRAN
Credential	:	DDS
Telephone Number	:	909-591-0077

Provider Enumeration Date	:	03/30/2018
Last Update Date	:	03/30/2018

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