Provider Demographics
NPI:1902248446
Name:DINH, MY THUY (OD)
Entity type:Individual
Prefix:
First Name:MY
Middle Name:THUY
Last Name:DINH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7314 N WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-7120
Mailing Address - Country:US
Mailing Address - Phone:405-437-0763
Mailing Address - Fax:405-437-0764
Practice Address - Street 1:7314 N WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116
Practice Address - Country:US
Practice Address - Phone:405-437-0763
Practice Address - Fax:405-437-0764
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2773152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200582690AMedicaid