Healthcare Provider Details

I. General information

NPI: 1386332856
Provider Name (Legal Business Name): MICHELLE THANH DINH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 INTERNATIONAL BLVD
OAKLAND CA
94601-2228
US

IV. Provider business mailing address

13465 GREENTREE AVE
GARDEN GROVE CA
92840-4615
US

V. Phone/Fax

Practice location:
  • Phone: 510-485-5925
  • Fax:
Mailing address:
  • Phone: 714-262-3096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS109098
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: