MEDICARE: KIM 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	122300000X	Dentist	32006	TX

General Provider Information

NPI Number	:	1811440944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM DINH

Provider Business Mailing Address
First Line	:	1812 DURHAM DR STE A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-2256
Country	:	US
Telephone Number	:	281-657-2406
Fax Number	:

Provider Business Practice Location Address
First Line	:	1914 GESSNER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-6371
Country	:	US
Telephone Number	:	713-595-8999
Fax Number	:

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

Provider Enumeration Date	:	07/25/2016
Last Update Date	:	07/25/2016

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Directions to “ KIM DINH ” Practice Location

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