Provider Demographics
NPI:1720108293
Name:DINH, ROBERT T
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:T
Last Name:DINH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 N RANCH WOOD TRL
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-2302
Mailing Address - Country:US
Mailing Address - Phone:714-612-6302
Mailing Address - Fax:
Practice Address - Street 1:2619 W EDINGER AVE STE A3
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-3501
Practice Address - Country:US
Practice Address - Phone:714-751-4072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA481001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice