Provider Demographics
NPI:1922147313
Name:VU, KHAI DINH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KHAI
Middle Name:DINH
Last Name:VU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MAPLE AVE W
Mailing Address - Street 2:140
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4308
Mailing Address - Country:US
Mailing Address - Phone:703-938-0559
Mailing Address - Fax:703-938-2005
Practice Address - Street 1:301 MAPLE AVE W
Practice Address - Street 2:140
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4308
Practice Address - Country:US
Practice Address - Phone:703-938-0559
Practice Address - Fax:703-938-2005
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014104441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice