Provider Demographics
NPI:1497271910
Name:SHINE BRIGHT DENTISTRY
Entity Type:Organization
Organization Name:SHINE BRIGHT DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-778-8822
Mailing Address - Street 1:3212 HARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-3902
Mailing Address - Country:US
Mailing Address - Phone:817-778-8822
Mailing Address - Fax:
Practice Address - Street 1:3212 HARWOOD RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021
Practice Address - Country:US
Practice Address - Phone:817-778-8822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27141261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
1022305422OtherNPI