Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 64856 | CA |
N | 122300000X | Dentist | DTT260 | HI |
N | 1223P0221X | Pediatric Dentist | D10931 | OR |
Y | 1223P0221X | Pediatric Dentist | S6-167 | NV |
NPI | 1093197378 |
---|---|
Provider Name | Dr. Alice Honey Trieu |
First Address | Lake Oswego, OR 97035-5768 |
Second Address | Las Vegas, NV 89129 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2015 |
Last Update Date | 02/05/2019 |