Provider Demographics
NPI:1720259070
Name:DR. AMY T. DINH, LLC
Entity Type:Organization
Organization Name:DR. AMY T. DINH, LLC
Other - Org Name:IDEAL VISION CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:THANH
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:225-766-8788
Mailing Address - Street 1:9828 BLUEBONNET BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-6461
Mailing Address - Country:US
Mailing Address - Phone:225-766-8788
Mailing Address - Fax:225-766-8003
Practice Address - Street 1:9828 BLUEBONNET BLVD STE E
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-6461
Practice Address - Country:US
Practice Address - Phone:225-766-8788
Practice Address - Fax:225-766-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1406-544T152W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty