Provider Demographics
NPI:1720285133
Name:VODINH, TAMDAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAMDAN
Middle Name:
Last Name:VODINH
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 1:2458 ASTRID CT
Mailing Address - Street 2:
Mailing Address - City:BROOKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20833-3252
Mailing Address - Country:US
Mailing Address - Phone:301-570-6740
Mailing Address - Fax:
Practice Address - Street 1:2458 ASTRID CT
Practice Address - Street 2:
Practice Address - City:BROOKEVILLE
Practice Address - State:MD
Practice Address - Zip Code:20833-3252
Practice Address - Country:US
Practice Address - Phone:301-570-6740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD139751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice