Provider Demographics
NPI:1902305469
Name:DINH DENTAL CORPORATION
Entity Type:Organization
Organization Name:DINH DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-751-4072
Mailing Address - Street 1:2619 W EDINGER AVE STE A3
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-3501
Mailing Address - Country:US
Mailing Address - Phone:714-751-4072
Mailing Address - Fax:
Practice Address - Street 1:2619 W EDINGER AVE STE A3
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-3501
Practice Address - Country:US
Practice Address - Phone:714-751-4072
Practice Address - Fax:714-751-4072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-09
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48100261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental