Provider Demographics
NPI:1316375314
Name:MY HANH H. TRIEU D.D.S A DENTAL PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MY HANH H. TRIEU D.D.S A DENTAL PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:MY HANH
Authorized Official - Middle Name:H
Authorized Official - Last Name:TRIEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-714-3410
Mailing Address - Street 1:8735 CENTER PKWY
Mailing Address - Street 2:#150
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-7923
Mailing Address - Country:US
Mailing Address - Phone:916-714-3410
Mailing Address - Fax:916-714-3510
Practice Address - Street 1:8735 CENTER PKWY
Practice Address - Street 2:#150
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-7923
Practice Address - Country:US
Practice Address - Phone:916-714-3410
Practice Address - Fax:916-714-3510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA455311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty