Individual provider Active NPI

Viet Thai Dinh, DMD

  • Dentist
  • Orange, CA
National Provider Identifier
1366602922
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
57092 Issued in CA
Practice address
530 S Main St
Orange, CA 92868-4525
Phone
(714) 571-3495
NPI assigned
Jun 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 57092 CA Primary

Addresses

Primary practice location

530 S Main St
Orange, CA 92868-4525

Mailing address

9682 Mansor Ave
Garden Grove, CA 92844-2931
Phone (714) 797-5702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160218001306 CA Order and Referring Only - DentistPractitioner - Dentist 8921303694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57092CAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1366602922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9682 MANSOR AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928442931",
            "telephone_number": "714-797-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684525",
            "telephone_number": "714-571-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINH",
        "first_name": "VIET",
        "middle_name": "THAI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "57092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.