MEDICARE: ANGIE DINH DDS, PA

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	20042	TX

General Provider Information

NPI Number	:	1760721914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGIE DINH DDS, PA

Provider Business Mailing Address
First Line	:	3425 S SHEPHERD DR STE 250
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3337
Country	:	US
Telephone Number	:	713-526-0056
Fax Number	:	713-526-0070

Provider Business Practice Location Address
First Line	:	3425 S SHEPHERD DR STE 250
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3337
Country	:	US
Telephone Number	:	713-526-0056
Fax Number	:	713-526-0070

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANGIE DINH
Credential	:
Telephone Number	:	713-526-0056

Provider Enumeration Date	:	02/07/2013
Last Update Date	:	02/07/2013

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