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General NPI Number Information
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NPI Number | 1932425204
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Entity Type | Individual
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Provider Name | JESSIE TRINH-MOORE D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/12/2010
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 400 N ZANG BLVD STE 100
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City | DALLAS
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State | TX
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Zip | 75208-4558
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Country | US
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Telephone | 214-390-9960
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Fax |
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Provider Business Mailing Address
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Address Line | 7604 QUAIL RIDGE CT
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City | FORT WORTH
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State | TX
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Zip | 76132-3538
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Country | US
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Telephone | 702-499-6330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 25313
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License Number State | TX
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