Provider Demographics
NPI:1407271935
Name:TRINH, HOA LIEN (DPD)
Entity Type:Individual
Prefix:MS
First Name:HOA
Middle Name:LIEN
Last Name:TRINH
Suffix:
Gender:F
Credentials:DPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 W. SPRUCE ST.
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382
Mailing Address - Country:US
Mailing Address - Phone:360-681-7089
Mailing Address - Fax:360-582-0138
Practice Address - Street 1:124 W. SPRUCE ST.
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382
Practice Address - Country:US
Practice Address - Phone:360-681-7089
Practice Address - Fax:360-582-0138
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADN60404578122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2059948Medicaid