Provider Demographics
NPI:1891820445
Name:DO, TRI MINH (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:TRI
Middle Name:MINH
Last Name:DO
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:PERRY
Other - Middle Name:TRI
Other - Last Name:DO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:4482 BARRANCA PKWY
Mailing Address - Street 2:#182
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-7701
Mailing Address - Country:US
Mailing Address - Phone:949-552-2288
Mailing Address - Fax:
Practice Address - Street 1:4482 BARRANCA PKWY
Practice Address - Street 2:#182
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-7701
Practice Address - Country:US
Practice Address - Phone:949-552-2288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA462581223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA46258OtherDENTAL LICENSE NUMBER