Provider Demographics
NPI:1003507195
Name:TRINH, TAMMIE MYLOAN (DDS)
Entity Type:Individual
Prefix:
First Name:TAMMIE
Middle Name:MYLOAN
Last Name:TRINH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LOAN
Other - Middle Name:MY
Other - Last Name:TRINH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3030 LBJ FWY STE 1700
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2759
Mailing Address - Country:US
Mailing Address - Phone:972-444-8888
Mailing Address - Fax:
Practice Address - Street 1:3030 LBJ FWY STE 1700
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-2759
Practice Address - Country:US
Practice Address - Phone:972-444-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2023-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX394591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program