Healthcare Provider Details

I. General information

NPI: 1720085194
Provider Name (Legal Business Name): BRIAN BINH TRINH D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 FRANKLIN ST STE 910
OAKLAND CA
94612-2824
US

IV. Provider business mailing address

1624 FRANKLIN ST STE 910
OAKLAND CA
94612-2824
US

V. Phone/Fax

Practice location:
  • Phone: 510-836-4811
  • Fax: 510-836-2338
Mailing address:
  • Phone: 510-836-4811
  • Fax: 510-836-2338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number45626
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: