Provider Demographics
NPI:1558824623
Name:VU, JULIE BAO THI (DDS)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:BAO THI
Last Name:VU
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 1:11250 KIRKLAND WAY
Mailing Address - Street 2:#102
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033
Mailing Address - Country:US
Mailing Address - Phone:425-739-9093
Mailing Address - Fax:425-822-3677
Practice Address - Street 1:11250 KIRKLAND WAY
Practice Address - Street 2:#102
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033
Practice Address - Country:US
Practice Address - Phone:425-739-9093
Practice Address - Fax:425-822-3677
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE610521401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty