Provider Demographics
NPI:1922298215
Name:VUONG, CANH TU (DDS)
Entity Type:Individual
Prefix:
First Name:CANH
Middle Name:TU
Last Name:VUONG
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 1:2451 S KING RD
Mailing Address - Street 2:STE B
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-2540
Mailing Address - Country:US
Mailing Address - Phone:408-270-2020
Mailing Address - Fax:408-270-2021
Practice Address - Street 1:2451 S KING RD
Practice Address - Street 2:STE B
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-2540
Practice Address - Country:US
Practice Address - Phone:408-270-2020
Practice Address - Fax:408-270-2021
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB29684-011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA249809Medicare UPIN