Provider Demographics
NPI:1265732382
Name:ACCESS DENTAL OF HAMPTON, P.A.
Entity type:Organization
Organization Name:ACCESS DENTAL OF HAMPTON, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:MAI
Authorized Official - Last Name:TRIEU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:214-943-1500
Mailing Address - Street 1:322 S HAMPTON ROAD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208
Mailing Address - Country:US
Mailing Address - Phone:214-943-1500
Mailing Address - Fax:
Practice Address - Street 1:322 S HAMPTON ROAD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208
Practice Address - Country:US
Practice Address - Phone:214-943-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21449122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty