Healthcare Provider Details

I. General information

NPI: 1851285035
Provider Name (Legal Business Name): MYO HEIN TUN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 COLISEUM DR
HAMPTON VA
23666-3200
US

IV. Provider business mailing address

2040 COLISEUM DR
HAMPTON VA
23666-3200
US

V. Phone/Fax

Practice location:
  • Phone: 650-255-8842
  • Fax:
Mailing address:
  • Phone: 650-255-8842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401420162
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: