Provider Demographics
NPI:1891954004
Name:DINH, THANHPHUONG (DMD)
Entity Type:Individual
Prefix:DR
First Name:THANHPHUONG
Middle Name:
Last Name:DINH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 ASHBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-7555
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 WOODBURY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4514
Practice Address - Country:US
Practice Address - Phone:407-674-6890
Practice Address - Fax:407-674-6891
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2010-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16702122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist