Provider Demographics
NPI:1730297391
Name:HO, TINH T (DDS)
Entity Type:Individual
Prefix:
First Name:TINH
Middle Name:T
Last Name:HO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7435 S EASTERN AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1508
Mailing Address - Country:US
Mailing Address - Phone:702-405-2381
Mailing Address - Fax:
Practice Address - Street 1:7435 S EASTERN AVE STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1508
Practice Address - Country:US
Practice Address - Phone:702-405-2381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV47221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100508179Medicaid