Healthcare Provider Details

I. General information

NPI: 1528277050
Provider Name (Legal Business Name): HUNG X DINH DMD A PROFESSIONAL DENTAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3402 E CHAPMAN AVE
ORANGE CA
92869-3813
US

IV. Provider business mailing address

3402 E CHAPMAN AVE
ORANGE CA
92869-3813
US

V. Phone/Fax

Practice location:
  • Phone: 714-744-2449
  • Fax:
Mailing address:
  • Phone: 714-744-2449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. HUNG XUAN DINH
Title or Position: PRESIDENT
Credential: D.M.D
Phone: 714-744-2449