Provider Demographics
NPI:1881961548
Name:VU, THAO NGUYEN (DDS)
Entity type:Individual
Prefix:
First Name:THAO
Middle Name:NGUYEN
Last Name:VU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:THAO
Other - Middle Name:VU
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11222 GARDEN GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843
Mailing Address - Country:US
Mailing Address - Phone:714-430-8454
Mailing Address - Fax:
Practice Address - Street 1:2700 N BELLFLOWER BLVD
Practice Address - Street 2:STE 212
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1129
Practice Address - Country:US
Practice Address - Phone:562-421-8883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA598881223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics