MEDICARE: DR. KERI TRAN DDS

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	22686	TX
2	122300000X	Dentist	0401412117	VA

General Provider Information

NPI Number	:	1992883821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERI TRAN DDS

Provider Business Mailing Address
First Line	:	6204 LITTLE RIVER TPKE
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312-1714
Country	:	US
Telephone Number	:	703-658-3000
Fax Number	:	703-658-3550

Provider Business Practice Location Address
First Line	:	6204 LITTLE RIVER TPKE
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312-1714
Country	:	US
Telephone Number	:	703-658-3000
Fax Number	:	703-658-3550

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	09/02/2010

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