Provider Demographics
NPI:1174655179
Name:VUONG, VICTORIA KIM (DDS)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:KIM
Last Name:VUONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3151 S. WHITE ROAD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148
Mailing Address - Country:US
Mailing Address - Phone:408-238-7646
Mailing Address - Fax:408-238-8096
Practice Address - Street 1:3151 S. WHITE ROAD
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148
Practice Address - Country:US
Practice Address - Phone:408-238-7646
Practice Address - Fax:408-238-8096
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA445551223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice