Xuan Kim Tran, DDS

Individual provider Active NPI General Practice Dentistry · Bladenboro, NC

NPI 1801005467 · NPPES record last updated Jun 28, 2010

Key facts

NPI
1801005467
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
8994 (NC)
Practice address
104 4TH Street
Bladenboro, NC 28320
Phone
(504) 339-5553
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
8994NCMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5826 LA
General Practice Dentistry 1223G0001X 8994 NC Yes

Addresses

Primary practice location

104 4TH Street
Bladenboro, NC 28320

Mailing address

104 4TH Street
Bladenboro, NC 28320
Phone (504) 339-5553

Other providers in Bladenboro, NC

All providers in Bladenboro, NC · General Practice Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.