Provider Demographics
NPI:1932416823
Name:LUU, VAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:VAN
Middle Name:
Last Name:LUU
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 1:4137 LILAC RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-5021
Mailing Address - Country:US
Mailing Address - Phone:415-407-1741
Mailing Address - Fax:
Practice Address - Street 1:5890 STONERIDGE DR STE 210
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-5824
Practice Address - Country:US
Practice Address - Phone:925-875-9292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA607951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice