Provider Demographics
NPI:1326235763
Name:VU, NAMTHUYEN T (DMD)
Entity Type:Individual
Prefix:DR
First Name:NAMTHUYEN
Middle Name:T
Last Name:VU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:NAMTHUYEN
Other - Middle Name:T
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:685 TWELVE BRIDGES DR
Mailing Address - Street 2:STE #E
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-8689
Mailing Address - Country:US
Mailing Address - Phone:949-439-3819
Mailing Address - Fax:
Practice Address - Street 1:685 TWELVE BRIDGES DR
Practice Address - Street 2:STE #E
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-8689
Practice Address - Country:US
Practice Address - Phone:949-439-3819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55882122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist