Provider Demographics
NPI:1689035420
Name:VU, TRANG TIFFANY (DMD)
Entity Type:Individual
Prefix:
First Name:TRANG TIFFANY
Middle Name:
Last Name:VU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5380 N FRESNO ST STE 106
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-6847
Mailing Address - Country:US
Mailing Address - Phone:559-226-4003
Mailing Address - Fax:559-226-4005
Practice Address - Street 1:5380 N FRESNO ST STE 106
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6847
Practice Address - Country:US
Practice Address - Phone:559-226-4003
Practice Address - Fax:559-226-4005
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
CA1016581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program