Provider Demographics
NPI:1255343588
Name:VU-RODRIGUES, HONG T (DDS)
Entity type:Individual
Prefix:DR
First Name:HONG
Middle Name:T
Last Name:VU-RODRIGUES
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 1:3000 E ANAHEIM ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3802
Mailing Address - Country:US
Mailing Address - Phone:562-438-9437
Mailing Address - Fax:562-438-9430
Practice Address - Street 1:3000 E ANAHEIM ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3802
Practice Address - Country:US
Practice Address - Phone:562-438-9437
Practice Address - Fax:562-438-9430
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA454181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB4541801Medicaid