Provider Demographics
NPI:1083398291
Name:TA, VU CHIEU (DDS)
Entity Type:Individual
Prefix:
First Name:VU
Middle Name:CHIEU
Last Name:TA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W MARSHALL ST APT 107
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-3955
Mailing Address - Country:US
Mailing Address - Phone:804-840-3888
Mailing Address - Fax:
Practice Address - Street 1:607 E NINE MILE RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND SPRINGS
Practice Address - State:VA
Practice Address - Zip Code:23075-1843
Practice Address - Country:US
Practice Address - Phone:804-326-9310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014185101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice