MEDICARE: VI THI HOANG DINH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2025020231	MO

General Provider Information

NPI Number	:	1043104011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VI THI HOANG DINH

Provider Business Mailing Address
First Line	:	4605 INDEPENDENCE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64124-2927
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4605 INDEPENDENCE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64124-2927
Country	:	US
Telephone Number	:	816-231-3333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2025
Last Update Date	:	06/05/2025

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