MEDICARE: DAVID MICHAEL VIERHUS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	36293	CA

General Provider Information

NPI Number	:	1003911868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MICHAEL VIERHUS DDS

Provider Business Mailing Address
First Line	:	1670 HILLSDALE AVE
Second Line	:	STE 20
City	:	SAN JOSE
State	:	CA
Zip	:	95124-3241
Country	:	US
Telephone Number	:	408-377-3214
Fax Number	:

Provider Business Practice Location Address
First Line	:	1670 HILLSDALE AVE
Second Line	:	STE 20
City	:	SAN JOSE
State	:	CA
Zip	:	95124-3241
Country	:	US
Telephone Number	:	408-377-3214
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	05/12/2015

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