Provider Demographics
NPI:1255463501
Name:DINH, HOAI THU (DDS)
Entity type:Individual
Prefix:DR
First Name:HOAI
Middle Name:THU
Last Name:DINH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15422 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90249-4524
Mailing Address - Country:US
Mailing Address - Phone:310-352-4939
Mailing Address - Fax:310-352-4043
Practice Address - Street 1:15422 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90249-4524
Practice Address - Country:US
Practice Address - Phone:310-352-4939
Practice Address - Fax:310-352-4043
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46377122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB46377OtherD.D.S