MEDICARE: ANH TRINH DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	019034288	IL

General Provider Information

NPI Number	:	1144904046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANH TRINH DDS

Provider Business Mailing Address
First Line	:	1255 S STATE ST UNIT 1202
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-3521
Country	:	US
Telephone Number	:	267-670-5499
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 CHICAGO RD
Second Line	:
City	:	CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-4160
Country	:	US
Telephone Number	:	708-755-2400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2023
Last Update Date	:	01/29/2025

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