Provider Demographics
NPI:1457603789
Name:DINH, NGOC DUNG TRAN (O,D)
Entity Type:Individual
Prefix:MRS
First Name:NGOC DUNG
Middle Name:TRAN
Last Name:DINH
Suffix:
Gender:F
Credentials:O,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6753 PARK ST E
Mailing Address - Street 2:
Mailing Address - City:FIFE
Mailing Address - State:WA
Mailing Address - Zip Code:98424-3828
Mailing Address - Country:US
Mailing Address - Phone:310-634-7648
Mailing Address - Fax:
Practice Address - Street 1:6753 PARK ST E
Practice Address - Street 2:
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424-3828
Practice Address - Country:US
Practice Address - Phone:310-634-7648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD.OD.60573156152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist