Healthcare Provider Details

I. General information

NPI: 1548887532
Provider Name (Legal Business Name): MINH N TRINH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 10/22/2020
Certification Date: 10/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15159 E COLFAX AVE UNIT B
AURORA CO
80011-5707
US

IV. Provider business mailing address

15159 E COLFAX AVE UNIT B
AURORA CO
80011-5707
US

V. Phone/Fax

Practice location:
  • Phone: 303-341-5437
  • Fax: 303-341-5547
Mailing address:
  • Phone: 303-341-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number00000018
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number00204474
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: