Basic Information
Provider Information
NPI: 1225479249
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VO
FirstName: TRINH
MiddleName: H
NamePrefix: MRS.
NameSuffix:  
Credential: D.M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9900 LINCOLN ST
Address2: 2ND FLOOR
City: TACOMA
State: WA
PostalCode: 984310001
CountryCode: US
TelephoneNumber: 2539684039
FaxNumber: 2539685919
Practice Location
Address1: 9900 LINCOLN ST
Address2: 2ND FLOOR
City: TACOMA
State: WA
PostalCode: 984310001
CountryCode: US
TelephoneNumber: 2539684039
FaxNumber: 2539685919
Other Information
ProviderEnumerationDate: 07/08/2013
LastUpdateDate: 07/08/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000XDN1856287MAY Dental ProvidersDentist 

No ID Information.


Home