Provider Demographics
NPI:1336633288
Name:VINH, AMANDA TONNU (DDS)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:TONNU
Last Name:VINH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6004 CAPE CORAL DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7211
Mailing Address - Country:US
Mailing Address - Phone:512-538-5725
Mailing Address - Fax:
Practice Address - Street 1:6751 N MACARTHUR BLVD STE 140
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2467
Practice Address - Country:US
Practice Address - Phone:214-431-4614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice