Provider Demographics
NPI:1851536395
Name:VU, KIM (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:
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 1:40 HILLSDALE MALL,
Mailing Address - Street 2:SEARS BLDG, 1ST FLOOR
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-3407
Mailing Address - Country:US
Mailing Address - Phone:650-212-1999
Mailing Address - Fax:650-212-2299
Practice Address - Street 1:40 HILLSDALE MALL,
Practice Address - Street 2:SEARS BLDG, 1ST FLOOR
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-3407
Practice Address - Country:US
Practice Address - Phone:650-212-1999
Practice Address - Fax:650-212-2299
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA397221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice