Healthcare Provider Details

I. General information

NPI: 1093642787
Provider Name (Legal Business Name): LINH BUI RDHAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 N 1ST ST
FRESNO CA
93726-0522
US

IV. Provider business mailing address

698 E OMAHA AVE
FRESNO CA
93720-2187
US

V. Phone/Fax

Practice location:
  • Phone: 559-224-3110
  • Fax:
Mailing address:
  • Phone: 559-797-7882
  • Fax: 559-797-7882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberAP828
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: